Leishmaniasis: Difference between revisions
Ostermayer (talk | contribs) (Text replacement - "Category:TropMed" to "Category:Tropical Medicine") |
ClaireLewis (talk | contribs) |
||
| Line 37: | Line 37: | ||
==Management== | ==Management== | ||
*Uncomplicated cutaneous leishmaniasis | *Uncomplicated cutaneous leishmaniasis | ||
**Topical Paromomycin | **Topical [[Paromomycin]] | ||
**Local injection of Stibogluconate or Meglumine antimoniate | **Local injection of Stibogluconate or Meglumine antimoniate | ||
*Complicated cutaneous leishmaniasis | *Complicated cutaneous leishmaniasis | ||
**PO Fluconazole or Miltefosine. | **PO [[Fluconazole]] or Miltefosine. | ||
**IV Stibogluconate, Meglumine, Amphotericin B, or Pentamidine | **IV Stibogluconate, Meglumine, [[Amphotericin B]], or Pentamidine | ||
*Visceral leishmaniasis | *Visceral leishmaniasis | ||
**Amphotericin B, Stibogluconate | **[[Amphotericin B]], Stibogluconate | ||
==Disposition== | ==Disposition== | ||
Revision as of 23:58, 15 July 2016
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
Diagnostic Evaluation
- CBC
- Chem
- Histology
- Culture
- Bone marrow or spleen biopsy (for visceral form)
- PCR
Management
- Uncomplicated cutaneous leishmaniasis
- Topical Paromomycin
- Local injection of Stibogluconate or Meglumine antimoniate
- Complicated cutaneous leishmaniasis
- PO Fluconazole or Miltefosine.
- IV Stibogluconate, Meglumine, Amphotericin B, or Pentamidine
- Visceral leishmaniasis
- Amphotericin B, Stibogluconate