CHALLENGES IN THE DIAGNOSIS OF POST-KALA-AZAR DERMAL LEISHMANIASIS A TRICKSTER DISEASE: CROSS-SECTIONAL STUDY AND AN OVERVIEW
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Abstract
Background Post-kala-azar dermal leishmaniasis (PKDL) manifests as a skin eruption after healing of visceral leishmaniasis (VL), either spontaneously or as a result of treatment. Tropical and subtropical areas are home to the disease leishmaniasis, which is brought on by the intracellular parasite. It is spread to people via the bite of the sand fly, Phlebotomus orientalis. Over all continents, the great majority of tropical regions have this infectious disease. On the other hand, the Middle East, Southeast Mexico, Central and South America, Northeastern Africa, Southern Europe, and South Asia exhibit greater case incidences. Leishmania donovani is a species of the subgenus Leishmania that mostly develops in the midgut and foregut of Phlebotomus orientalis, a kind of sand fly .
Material & Methods : We studied 100 cases of PKDL . The diagnosis was based on clinical presentation, positive slit skin smear and histopathologic studies. Clinical features were analysed and cytological and histopathological correlation was done.
Results: There were 64 (64%) males and 56 (56%) females. Generalized lymphadenopathy was present in seven cases. Slit skin smears revealed LeishmanDonovan bodies (LDBs) in 78 (78%) cases. Biopsy specimens revealed LDBs in 38(38%) cases only. Fine needle aspiration from cervical lymph nodes in 6(6%) cases demonstrated LDBs.
Conclusions: High positivity for LDBs were seen on slit smear examination of lesions. This study emphasizes the need to be aware that though the biopsy is gold standard for final diagnosis of the lesion, LDBs were detected more in the slit smears( 78% ) as compared to detection of LDBs in 38% cases on histopathology of PKDL cases . Hence slit smear examination may be more useful as compared to histopathology in PKDL cases.
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Fariha Kauser
Health practitioner & Ex Medical Educationist from University of Dundee, Scotland
Anshoo Agarwal
Northern Border University, Kingdom of Saudi Arabia
Nida Suhail
Department of Medical Laboratory Technology, Faculty of Applied Medical Sciences, Northern Border University, Arar, Saudi Arabia
Kabir Singal
JSS Medical College , Mysore, Karnataka, India
Harmanjeet Singh
Mahatma Gandhi Memorial Medical College, Jamshedpur
Rashad Othman
Northern Border University, Kingdom of Saudi Arabia
Wajid Ali Chatha
Faculty of Medicine, Northern Border University, Arar, Kingdom of Saudi Arabia
Raghad Qasim Alshalan
Medical student, Northern Border University, Arar, Kingdom of Saudi Arabia
Fajer Atallah
Medical student, Northern Border University, Arar, Kingdom of Saudi Arabia