Short Communication

Clinical and Laboratory Analysis of Patients with Leishmaniasis: A Retrospective Study from a Tertiary Care Center in New Delhi

Abstract

Background: Leishmaniasis manifests as visceral (VL), cutaneous (CL) or a dermal sequel of VL, known as Post kala-azar dermal leishmaniasis (PKDL). The aim of the study was to analyze the clinical and laboratory features of cases diagnosed with leishmaniasis.

Methods: This hospital-based retrospective study included all cases of VL, PKDL, and CL diagnosed between Jan 2011 to Jan 2016 at All India Institute of Medical Sciences, New Delhi. Clinical and laboratory profile of the diagnosed cases were analyzed in detail. All diagnosed cases were mapped according to the state and the district from which the cases originated.

Results: A total of 91 VL cases and 4 PKDL cases were reviewed. Only one case of CL (1 female) and mucocutaneous leishmaniasis (1 female) were observed during the study period. Majority of the cases of VL (75/91) originated from Bihar. The most common presenting symptoms in all our patients were fever (97.8%), weight loss (40.6%) and abdominal discomfort (17.6%) while the most common presenting signs were hepatosplenomegaly (45.8%), isolated splenomegaly (23.1%) and skin pigmentation (11%). The most common laboratory abnormality was anaemia followed by thrombocytopenia and leucopenia.

Conclusion: VL is globally recognized as a neglected tropical disease. Even after continued effort to bring down its transmission in India, it continues to affect the endemic states with reports from new pockets.

Okwor I, Uzonna J. Social and economic burden of human leishmaniasis. Am J Trop Med Hyg. 2016;94:489-493.

Alvar J, Velez ID, Bern C, Herrero M, Desjeux P, Cano J, Jannin J, den Boer M. Leishmaniasis worldwide and global estimates of its incidence. PLoS One. 2012;7:e35671.

Sharma NL, Mahajan VK, Kanga A et al. Localized cutaneous leishmaniasis due to Leishmania donovani and Leishmania tropica: Preliminary findings of the study of 161 new cases from a new endemic focus in Himachal pradesh, India. Am J Trop Med Hyg. 2005;72:819-824.

Kumar R, Bumb RA, Ansari NA, Mehta RD, Salotra P. Cutaneous leishmaniasis caused by Leishmania tropica in Bikaner, India: Parasite identification and characterization using molecular and immunologic tools. Am J Trop Med Hyg. 2007;76:896-901.

Daulatabad D, Singal A, Dhawan A, Pandhi D, Sharma S. Mucocutaneous leishmaniasis caused by Leishmania donovani infection in an Indian man. Int J Dermatol. 2015;54:680-684.

Pulimood SA, Rupali P, Ajjampur SS, Thomas M, Mehrotra S, Sundar S. Atypical mucocutaneous involvement with Leishmania donovani. Natl Med J India. 2012;25:148-150.

Karimbil SK, Kumari S, Celine MI, Joy A. A chronic mutilating rhinopathy with a delayed diagnosis of mucocutaneous leishmaniasis. Int J Dermatol. 2010;49:426-429.

Mondal D, Khan MG. Recent advances in post-kala-azar dermal leishmaniasis. Curr Opin Infect Dis. 2011;24:418-422.

Srivastava P, Gidwani K, Picado A et al. Molecular and serological markers of Leishmania donovani infection in healthy individuals from endemic areas of Bihar, India. Trop Med Int Health. 2013;18:548-554.

Chufal SS, Pant P, Chachra U, Singh P, Thapliyal N, Rawat V. Role of haematological changes in predicting occurrence of leishmaniasis- a study in kumaon region of Uttarakhand. J Clin Diagn Res. 2016;10:Ec39-43.

Kumar A, Vinita R, Thapliyal N, Saxena SR. Kala-azar--a case series from non endemic area, Uttarakhand. J Commun Dis. 2012;44:145-149.

Ramesh V, Kaushal H, Mishra AK, Singh R, Salotra P. Clinico-epidemiological analysis of post kala-azar dermal leishmaniasis (pkdl) cases in India over last two decades: A hospital based retrospective study. BMC Public Health. 2015;15:1092.

Barrett MP, Croft SL. Management of trypanosomiasis and leishmaniasis. Br Med Bull. 2012;104:175-196.

Chakrabarti S, Sarkar S, Goswami BK, Sarkar N, Das S. Clinico-hematological profile of visceral leishmaniasis among immunocompe-tent patients. Southeast Asian J Trop Med Public Health. 2013;44:143-149.

Raina S, Mahesh DM, Kaul R, Satindera KS, Gupta D, Sharma A, Thakur S. A new focus of visceral leishmaniasis in the Himalayas, India. J Vector Borne Dis. 2009;46:303-306.

Dhingra KK, Gupta P, Saroha V, Setia N, Khurana N, Singh T. Morphological findings in bone marrow biopsy and aspirate smears of visceral kala azar: A review. Indian J Pathol Microbiol. 2010;53:96-100.

Mohebali M. Visceral leishmaniasis in Iran: Review of the epidemiological and clinical features. Iran J Parasitol. 2013;8:348-358.

Mohebali M, Edrissian GH, Shirzadi MR et al. An observational study on the current distribution of visceral leishmaniasis in different geographical zones of Iran and implication to health policy. Travel Med Infect Dis. 2011;9:67-74.

Singh OP, Sundar S. Developments in diagnosis of visceral leishmaniasis in the elimination era. J Parasitol Res. 2015;2015:239469.

Chappuis F, Sundar S, Hailu A, Ghalib H, Rijal S, Peeling RW, Alvar J, Boelaert M. Visceral leishmaniasis: What are the needs for diagnosis, treatment and control? Nat Rev Microbiol. 2007;5:873-882.

Elmahallawy EK, Sampedro Martinez A, Rodriguez-Granger J et al. Diagnosis of leishmaniasis. J Infect Dev Ctries. 2014;8:961-972.

Singh OP, Singh B, Chakravarty J, Sundar S. Current challenges in treatment options for visceral leishmaniasis in India: A public health perspective. Infect Dis Poverty. 2016;5:19.

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IssueVol 12 No 4 (2017) QRcode
SectionShort Communication(s)
Keywords
Visceral leishmaniasis Cutaneous leishmaniasis PKDL

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How to Cite
1.
GUPTA N, KANT K, MIRDHA BR. Clinical and Laboratory Analysis of Patients with Leishmaniasis: A Retrospective Study from a Tertiary Care Center in New Delhi. Iran J Parasitol. 2017;12(4):632-637.