Leishmaniasis Diagnosis and Clinical Aspects

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Questions and Answers

Which specimen is NOT commonly used for culture in diagnosing cutaneous and mucocutaneous leishmaniasis?

Lymph node

Lung tissue biopsy (correct)

Bone marrow aspirate

Splenic aspirate

Which serologic technique has high specificity and is particularly useful in diagnosing cutaneous leishmaniasis?

ELISA

Complement fixation test

Direct Agglutination Test (DAT)

Montenegro intradermal reaction (correct)

What aspect of cellular immunity changes following an infection with Leishmania donovani?

It becomes low in all forms of leishmaniasis.

It becomes positive within 24-48 hours. (correct)

It is uniformly high in cutaneous leishmaniasis.

It is always high in disseminated visceral leishmaniasis.

Which test is utilized for the survey of populations and monitor treatment effectiveness in leishmaniasis?

Leishmanin skin test Signup and view all the answers

What is a key prevention strategy for controlling the spread of leishmaniasis?

Improvement of human dwellings Signup and view all the answers

What is the main first-line therapy for leishmaniasis?

Sodium stibogluconate Signup and view all the answers

Which clinical feature is NOT commonly associated with Leishmania infections?

Skin rash Signup and view all the answers

In the treatment of visceral leishmaniasis (VL), which of the following is known to be less toxic compared to traditional Amphotericin B?

Liposomal Amphotericin B Signup and view all the answers

Which of the following is a common symptom of Leishmania infection observed in both children and adults?

Anemia Signup and view all the answers

What effect do synthetic pyrethroids have in the context of Leishmania control?

They are effective insecticides Signup and view all the answers

What is the primary mode of transmission for Trypanosoma brucei?

Bite of the tsetse fly Signup and view all the answers

Which stage of Trypanosoma brucei is typically detected in blood tests?

Trypomastigote Signup and view all the answers

Which clinical manifestation is characteristic of Gambian trypanosomiasis?

Winterbottom's sign Signup and view all the answers

What is the effective treatment during the acute stage of Trypanosomiasis?

Pentamidine and suramin Signup and view all the answers

Which species is associated with the Rhodesian sleeping sickness?

Trypanosoma brucei rhodesiense Signup and view all the answers

In the diagnosis of Trypanosomiasis, which method is NOT typically used?

Magnetic resonance imaging Signup and view all the answers

What is one of the earliest signs of Trypanosomiasis after infection?

Chancre at the inoculation site Signup and view all the answers

Which of the following treatments is less effective against Rhodesian sleeping sickness?

Eflornithine Signup and view all the answers

The reduction of contact with tsetse flies can be achieved through which method?

Using traps and insecticides Signup and view all the answers

Which symptom is commonly associated with the acute stage of Trypanosomiasis?

Tachycardia Signup and view all the answers

Study Notes

Cutaneous and Mucocutaneous Leishmaniasis

Diagnosis:
- Microscopy: Giemsa stain for amastigotes in blood, lymph node, or tissue biopsy.
- Culture: NNN medium for promastigotes from bone marrow, spleen, lymph node, or tissue biopsy.
- Serology: IFA, DAT, ELISA, IFAT, complement fixation for leishmaniasis antibodies.
- Skin test: Montenegro Intradermal reaction for population surveys and treatment monitoring.

Visceral Leishmaniasis (Kala-azar, Dum Dum Fever)

Causative agent: Leishmania donovani
Geography: Global variations in prevalence.
Clinical presentation: Fever, splenomegaly, hepatomegaly, weight loss, anemia, cough, diarrhea, lymphadenopathy, pancytopenia, hypergammaglobulinemia, skin darkening.
Diagnosis:
- Microscopy: Giemsa stain for amastigotes in bone marrow, spleen, or lymph node aspirate.
- Culture: NNN medium for promastigotes from bone marrow, spleen, or lymph node aspirate.
- Serology: Indirect hemagglutination, ELISA, immunofluorescence, for Leishmania antibodies.
Treatment:
- First-line: Antimonial drugs: SbV, sodium stibogluconate, methylglucamine antimonite.
- Second-line: Amphotericin B, pentamidine, metronidazole, nifurtimox.
- Liposomal AMB (L-AMB): Less toxic option, effective in both immunocompetent and immunocompromised patients.

Human African Trypanosomiasis (Sleeping Sickness)

Causative agents: Trypanosoma brucei gambiense (West and Central Africa) and Trypanosoma brucei rhodesiense (East Africa).
Transmission: Bite of infected tsetse fly (Glossina spp.).
Clinical presentation:
- Early stage: Chancre at the inoculation site, fever, headache, myalgia, tachycardia, dizziness, rash.
- Later stage:
  - Gambian trypanosomiasis: Winterbottom's sign (enlarged posterior cervical lymph nodes).
  - Rhodesian trypanosomiasis: More rapid progression, CNS invasion (headache, mental dullness, tremors, hyperesthesia).
Diagnosis:
- Microscopy: Giemsa stain for trypomastigotes in blood, lymph node aspirate, or CSF.
- Serology: Indirect hemagglutination, ELISA, Immunofluorescence.
Treatment:
- Early stage: Pentamidine, suramin.
- Later stage: Melarsoprol, tryparsamide, DL-alpha-diflouoromethylornithine (DFMO, Eflornithine).
- Eflornithine: Less effective against Trypanosoma brucei rhodesiense.

Prevention and Control of Leishmaniasis

Improved housing: Separation of animal stalls from homes.
Health education: Awareness of disease transmission and prevention.
Insecticides: Synthetic pyrethroids, gentian violet in blood transfusions.

Prevention and Control of African Trypanosomiasis

Tsetse fly control: Traps, screens, insecticides.
Diagnosis and treatment of infected individuals.
Tsetse belt: Endemic area in Africa requiring control measures.

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Description

Test your knowledge on the diagnosis and clinical presentation of Cutaneous, Mucocutaneous, and Visceral Leishmaniasis. This quiz covers microscopy, culture techniques, serology tests, and more. Understand the geographical variations and the causative agents associated with these diseases.