| Disease |
KALA - AZAR (VISCERAL LEISHMANIASIS) |
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| Quotation |
“Ingenuity, knowledge, and organization after but cannot cancel humanity’s vulvenrability to invasion by parasitic forms of life. Infectious disease which anteceded the emergence of humanity will last as long as humanity itself, and will surely remain, as it has been hitherto, one of the fundamental parameters and determinants of human history” |
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| Definition |
A zoonotic infection caused by leishmania genus transmitted form animal reservoirs (rodents, canines) to many by bite of Phlebotomus sandflies and manifesting in cutaneous form with nodules, or Viceral type with varied general features as detailed below. |
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| Prognosis |
Without treatment 90% would die within 2 years. Curable in 90% with early therapy, but carries a mortality of 25% in advanced cases. Even with treatment up to 10% develop Post kala-azar Dermal leishmaniasis. |
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| General Measures |
Blood transfusion, as indicatedTreatment of complicating super-infectionsAttention to nutrition |
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| Advice to Patient |
Nil specific |
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| Follow Up |
Follow up at 3, 6, and 12 months to detect relapses. Monitoring of liver, and renal function, and repeated ECGs during prolonged therapy. |
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| Inadequate Response |
Consider resistant organism, and treat as detailed above. |
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| Prevention |
DDT to destroy sandflies. Insect repellents, and permithrin coasted fine netting for travelers. Elimination of diseased dogs. |
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| Reference From |
http://www.baylor.edu/~Charles_Kemp/leishamaniasis.html |
