ArtsAutosBooksBusinessEducationEntertainmentFamilyFashionFoodGamesGenderHealthHolidaysHomeHubPagesPersonal FinancePetsPoliticsReligionSportsTechnologyTravel

The Health Significance Of The Diagnosis, Prognosis And Laboratory Investigations Of Visceral Leishmaniasis

Updated on March 31, 2014

Diagnosing Visceral Leishmaniasis


Diagnosis Of Kala-azar

Any chronic pyrexial disease occurring in an endemic area associated with hepatosplenomegaly, should raise the possibility of Kala-azar. Diagnosis is confirmed by serology, biochemical tests and demonstration of the parasite. Complement fixation test using an antigen prepared from Kedrowsky’s acid-fast bacillus is positive in 95% case from the third week of illness. Conditions like chronic tuberculosis, lepromatous leprosy, post Kala-azr dermal leishmaniasis and Chaga’s disease may rarely give positive complement fixation test.

Napier’s aldehyde test is a simple bedside test helpful in the diagnosis of chronic kala-azar in dispensary practice. Two drops of commercial formalin (formaldehyde 40%) is added to 1 ml of patient’s serum in a test tube and set aside for 24 hours. In a positive test, the serum solidifies and becomes opaque and white in colour like hard boiled egg-white. The positivity can be graded depending on the speed of the reaction. If gellification occurs within 20 minutes, it is recorded as +++; if within 2 hours, it is recorded as ++; and if after 24 hours, it is taken as +. Positive reaction is diagnostic of Kala-azar in India, especially. In a doubtful case, the serum sets within 24 hours, and it is white in colour but translucent. In such cases, follow-up may be helpful. When the test is negative, the serum remains fluid throughout.

The L.D bodies can be demonstrated microscopically in material obtained by splenic puncture (95%), bone marrow smears (85 to 90%) and in a smaller proportion of liver aspiration smears. They can also be demonstrated in tissue sections by special staining. The parasites can be demonstrated in peripheral blood within monocytes, especially if the buffy coat is examined. The organism can be grown in vitro from bone marrow or spleen puncture aspirate in N.N.N medium.

Differential Diagnosis: All chronic prolonged febrile illnesses and conditions producing hepatosplenomegaly enter the differential diagnosis. Important among these are enteric fever, malaria, acute military tuberculosis, brucellosis, septicemia, hepatic amoebiasis, acute leukemias and lymphoma. In places like India, may places are endemic for malaria and leishmaniasis and these infections therefore can coexist.

Laboratory Maneuvers In Visceral Leishmaniasis


Laboratory Investigations In Kala Azar

Blood: There is moderate anemia with hemoglobin levels around 7 to 9 g/dl. Anemia is due to nutritional deficiency as well as infection. The total leucocyte count is reduced and it varies from 1000 to 3000/cmm, the granulocytes being depressed more. There is relative increase in lymphocytes and monocytes. Most of the cases show thrombocytopenia. Serum proteins show gross alternation. Albumin is lowered and globulins are considerably elevated. IgG and IgM are elevated and C3 complement is low. Advanced cases may show biochemical evidence of hepatic dysfunction.

Complications: Cancrum oris, dysentery, pneumonias, severe anemia, jaundice, hemorrhages and generalized anasarca may develop in untreated cases. Pulmonary tuberculosis may coexist in a few. About 10% of cases may develop cirrhosis of the liver as a late complication after treatment.

Course And Prognosis: If left untreated, the mortality may be as high as 70 to 90% in two years. Death is due to complications like noma, cancrum oris, pneumonia, dysentery and hemorrhages. With prompt therapy, 90% of cases are cured.

© 2014 Funom Theophilus Makama


    0 of 8192 characters used
    Post Comment

    No comments yet.


    This website uses cookies

    As a user in the EEA, your approval is needed on a few things. To provide a better website experience, uses cookies (and other similar technologies) and may collect, process, and share personal data. Please choose which areas of our service you consent to our doing so.

    For more information on managing or withdrawing consents and how we handle data, visit our Privacy Policy at:

    Show Details
    HubPages Device IDThis is used to identify particular browsers or devices when the access the service, and is used for security reasons.
    LoginThis is necessary to sign in to the HubPages Service.
    Google RecaptchaThis is used to prevent bots and spam. (Privacy Policy)
    AkismetThis is used to detect comment spam. (Privacy Policy)
    HubPages Google AnalyticsThis is used to provide data on traffic to our website, all personally identifyable data is anonymized. (Privacy Policy)
    HubPages Traffic PixelThis is used to collect data on traffic to articles and other pages on our site. Unless you are signed in to a HubPages account, all personally identifiable information is anonymized.
    Amazon Web ServicesThis is a cloud services platform that we used to host our service. (Privacy Policy)
    CloudflareThis is a cloud CDN service that we use to efficiently deliver files required for our service to operate such as javascript, cascading style sheets, images, and videos. (Privacy Policy)
    Google Hosted LibrariesJavascript software libraries such as jQuery are loaded at endpoints on the or domains, for performance and efficiency reasons. (Privacy Policy)
    Google Custom SearchThis is feature allows you to search the site. (Privacy Policy)
    Google MapsSome articles have Google Maps embedded in them. (Privacy Policy)
    Google ChartsThis is used to display charts and graphs on articles and the author center. (Privacy Policy)
    Google AdSense Host APIThis service allows you to sign up for or associate a Google AdSense account with HubPages, so that you can earn money from ads on your articles. No data is shared unless you engage with this feature. (Privacy Policy)
    Google YouTubeSome articles have YouTube videos embedded in them. (Privacy Policy)
    VimeoSome articles have Vimeo videos embedded in them. (Privacy Policy)
    PaypalThis is used for a registered author who enrolls in the HubPages Earnings program and requests to be paid via PayPal. No data is shared with Paypal unless you engage with this feature. (Privacy Policy)
    Facebook LoginYou can use this to streamline signing up for, or signing in to your Hubpages account. No data is shared with Facebook unless you engage with this feature. (Privacy Policy)
    MavenThis supports the Maven widget and search functionality. (Privacy Policy)
    Google AdSenseThis is an ad network. (Privacy Policy)
    Google DoubleClickGoogle provides ad serving technology and runs an ad network. (Privacy Policy)
    Index ExchangeThis is an ad network. (Privacy Policy)
    SovrnThis is an ad network. (Privacy Policy)
    Facebook AdsThis is an ad network. (Privacy Policy)
    Amazon Unified Ad MarketplaceThis is an ad network. (Privacy Policy)
    AppNexusThis is an ad network. (Privacy Policy)
    OpenxThis is an ad network. (Privacy Policy)
    Rubicon ProjectThis is an ad network. (Privacy Policy)
    TripleLiftThis is an ad network. (Privacy Policy)
    Say MediaWe partner with Say Media to deliver ad campaigns on our sites. (Privacy Policy)
    Remarketing PixelsWe may use remarketing pixels from advertising networks such as Google AdWords, Bing Ads, and Facebook in order to advertise the HubPages Service to people that have visited our sites.
    Conversion Tracking PixelsWe may use conversion tracking pixels from advertising networks such as Google AdWords, Bing Ads, and Facebook in order to identify when an advertisement has successfully resulted in the desired action, such as signing up for the HubPages Service or publishing an article on the HubPages Service.
    Author Google AnalyticsThis is used to provide traffic data and reports to the authors of articles on the HubPages Service. (Privacy Policy)
    ComscoreComScore is a media measurement and analytics company providing marketing data and analytics to enterprises, media and advertising agencies, and publishers. Non-consent will result in ComScore only processing obfuscated personal data. (Privacy Policy)
    Amazon Tracking PixelSome articles display amazon products as part of the Amazon Affiliate program, this pixel provides traffic statistics for those products (Privacy Policy)