Leishmaniasis: Difference between revisions
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==Differential Diagnosis== | ==Differential Diagnosis== | ||
*Cutaneous/Mucocutaneous-bacterial skin infection | *Cutaneous/Mucocutaneous-bacterial skin infection | ||
*malignancy | |||
*sarcoidosis | |||
*spider bite | |||
*tropical ulcer | |||
*yaws | |||
*cutaneous [[anthrax]] | |||
*nocardia and actinomycosis | |||
*cutaneous tuberculosis | |||
==Workup== | ==Workup== | ||
| Line 25: | Line 33: | ||
*Complicated CL- PO Fluconazole or Miltefosine. IV Stibogluconate, Meglumine, Amphotericin B, or Pentamidine | *Complicated CL- PO Fluconazole or Miltefosine. IV Stibogluconate, Meglumine, Amphotericin B, or Pentamidine | ||
*Visceral- Amphotericin B, Stibogluconate | *Visceral- Amphotericin B, Stibogluconate | ||
==See Also== | |||
*[[Travel Skin Conditions]] | |||
==Source== | ==Source== | ||
*Uptodate | *Uptodate | ||
*Tintinalli | *Tintinalli | ||
[[Category:ID]] | |||
[[Category:TropMed]] | |||
Revision as of 22:32, 9 June 2014
Background
- Vector: sandfly
- Occurs sporadically in rural Africa, Asia, Mediterranean, Central/South America
- Wide variety of symptoms given numerous species of protozoa
- 500,000 new cases and 60,000 deaths each year
Clinical Features
- Cutaneous- single to diffuse nodules/plagues with central clearing/eschar/fibrinous exudate
- Mucocutaneous-mucosal destruction, deformity nasal blockage, bleeding, increased secretions, sloughing of dead tissue, dysphonia, odynophagia, respiratory distress
- Visceral (Kala-azar)-darkening of skin, malaise, fever, weight lost, splenomegaly with advanced disease causing hepatic dysfunction, jaundice, ascites, thrombocytopenia, and hemorrhagic complications
- Anemia, neutropenia, thrombocytopenia, hypoalbuminemia, hyperbilirubinemia
Differential Diagnosis
- Cutaneous/Mucocutaneous-bacterial skin infection
- malignancy
- sarcoidosis
- spider bite
- tropical ulcer
- yaws
- cutaneous anthrax
- nocardia and actinomycosis
- cutaneous tuberculosis
Workup
- CBC
- Chem
- Histology
- Culture
- Bone marrow or spleen biopsy for VL
- PCR
- Contact CDC Parasitic Disease Public Inquiries (404)-718-4745 for transport medium and instructions
Management
- Uncomplicated CL-topical Paromomycin, local injection of Stibogluconate or Meglumine antimoniate
- Complicated CL- PO Fluconazole or Miltefosine. IV Stibogluconate, Meglumine, Amphotericin B, or Pentamidine
- Visceral- Amphotericin B, Stibogluconate
See Also
Source
- Uptodate
- Tintinalli