Visceral Leishmaniasis

Symptoms

• Fever
• Lymphadenopathy

• Hepatosplenomegaly

Labs: pancytopenia (2/2 hyperspenism), increased IgG (asmastigotes stimulate RES)

Strains:

• Leishmania donovani – India, East Africa
• Transmitted by Phlebotomus
• Leishmania infantum – New World
• Transmitted by Lutzomyia
• 90% of all VL occurs in Sudan, India, Bangladesh, Nepal and Brazil

Ddx:

• Hodgkins or Non-Hodgkins Lympohoma (but LAD > splenomegaly)
• Tropical splenomegaly syndrome (hepatsplenomegaly but IgM increased not IgG)
• Hepatic schistosomiasis (usu no fever/LAD)
• Cirrhosis w/ portal hypertension (usu no fever, LAD, small splenomegaly)
• Chronic leukemia (usu. inc WBC)
• Chronic brucellosis (usu. NO splenomegaly)