Visceral leishmaniasis

Visceral leishmaniasis in the Old World has two varieties - Mediterranean (children's) visceral leishmaniasis (HL) and Indian visceral leishmaniasis (adult leishmaniasis, kala-azar).

What causes visceral leishmaniasis?

Visceral leishmaniasis is a typical zoonosis with a natural foci. The reservoir of the causative agent (L. Infantum) in wild conditions is various representatives of the canine family (Canidae) - fox, jackal, corsac, etc., and in the settlements - dogs. In animals leishmaniasis develops slowly, and the source of infection can be individuals and without visible external signs of the disease. In dogs, along with lesions of internal organs, skin lesions (mainly on the head) are often observed, which are the site of localization of leishmanias and serve as a source of infection for mosquitoes. Transmission of the pathogen from sick wild animals or dogs to humans occurs through a mosquito bite. Suffer from visceral leishmaniasis mostly children of preschool age, much less often - adults.

Symptoms of visceral leishmaniasis

The incubation period of visceral leishmaniasis may be from 2 weeks to 1 year or more, but on average is 3-5 months, so cases are recorded year-round, with a predominance in the winter and spring months. Often in children under 1.5 years of age at the site of a mosquito bite, one can detect a primary affect - a small nodule of pale pink color. Disease visceral leishmaniasis is characterized by the gradual development of intermittent fever. Another symptom of visceral leishmaniasis is splenomegaly: the spleen increases rapidly and evenly, and the liver is usually less intense. Sometimes there is an increase in peripheral lymph nodes. Characteristic signs of visceral leishmaniasis are also: progressive anemia, leukopenia, thrombocytopenia, hyper- and dysproteinemia, increased ESR, increased exhaustion, hemorrhagic syndrome. Usually there are complications associated with the attachment of a secondary infection. In infants, all clinical manifestations are more acute, in adults, visceral leishmaniasis often occurs chronically; duration of the disease is from 3 months to 1 year, less often to 1.5-3 years. In a part of infected, mainly adults, visceral leishmaniasis has a subclinical course and can manifest itself in 2-3 years or even 10-20 years under the influence of provoking factors (HIV infection, etc.).

Visceral leishmaniasis, as an AIDS-associated infection, has one important, fundamental difference from other opportunistic infestations (infections), namely: it is non-contagious, i.e. It is not transmitted directly from the source (animal, human) of invasion to man. In southern European countries in the early 1990s, 25-70% of cases of visceral leishmaniasis in adults were associated with HIV infection, and 1.5-9% of AIDS patients suffered from HLV. Of the 692 reported cases of co-infection, about 60% were in Italy and France. The overwhelming majority of cases of co-infection (90%) occurred in men aged 20-40 years.

In Russia, the first case of HIV / HIV co-infection was diagnosed in 1991.

Treatment of visceral leishmaniasis

Without specific treatment, 98-99% of patients with visceral leishmaniasis die from severe complications and an associated infection. Correct diagnosis and timely treatment of visceral leishmaniasis leads to complete recovery.