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Splenomegaly
Published in K. Gupta, P. Carmichael, A. Zumla, 100 Short Cases for the MRCP, 2020
K. Gupta, P. Carmichael, A. Zumla
Five common causes are: Chronic myeloid leukaemia.Myelofibrosis.Polycythaemia rubra vera.Tropical splenomegaly syndrome (P. malariae).Kala-Azar (visceral leishmaniasis).
Pulmonary Disease of Parasitic Cause
Published in Lourdes R. Laraya-Cuasay, Walter T. Hughes, Interstitial Lung Diseases in Children, 2019
This hemoflagellate protozoan causes kala-azar. The bite of the infected sandfly introduces leptomonads into the skin. These are engulfed by the macrophages within which they multiply and are carried by the bloodstream to the fixed cells of the reticuloendothelial system (skin, intestines, lung, bone marrow, liver, spleen). Tremendous proliferation of macrophages, expansion of the red bone marrow, and enlargement of the liver and spleen follow. The lung is involved in common with other tissues that contain reticuloendothelial cells. Pulmonary infection is a negligible part of kala-azar. When seen in interstitial alveolar cells, the parasites microscopically resemble T. gondii and the spores of Histoplasma capsulatum, requiring careful staining to differentiate them.
The Second Half of the Nineteenth Century
Published in Arturo Castiglioni, A History of Medicine, 2019
A number of trypanosomes have been found to be pathogenic. Though the earliest discovered (in the frog) and T. lewisi in the rat appear to be harmless, T. evansi (Griffith evans, 1880) was shown to be the cause of surra, a disease of ungulates. Sir David bruce (1855-1931) found that T. brucei (1894) caused the regularly fatal nagana, the animal disease transmitted by the tsetse fly (Glos-sina morsitans). In the equally fatal disease of man, T. gambiense (J. E. dutton, 1901) was found to be transmitted by another tsetse fly, Glossina palpalis. In addition to various other animal diseases, caused by T. equiperdum, T. theileri, and T. dimorphon,we should record the South American disease named (1909) for Carlos chagas (1879-1934), caused by T. cruzi and transmitted by biting insects of the family Reduviidas. Another group of parasitic diseases is represented by kala-azar, a tropical splenomegaly, caused by the flagellated body Leishmania donovani (1903). A cutaneous form —Aleppo or Delhi boil —is caused by L. tropica (J. H. wright, 1903). Still another group, Babesia (piroplasma), named after their Rumanian discoverer, V. babes (1854-1926), has been found to cause a number of relatively unimportant diseases of man and animals. Toxoplasma pyogenes was reported by A. Castellani (1914) as the cause of a grave human disease — toxoplasmosis.
Visceral leishmaniasis elimination in India: progress and the road ahead
Published in Expert Review of Anti-infective Therapy, 2022
Om Prakash Singh, Shyam Sundar
While the VL elimination programme launched by the governments of India, Bangladesh and Nepal in 2005 has made significant strides, many challenges remain, including the timely availability of suitable drug treatments [3]. Treatment for VL is limited to the currently available chemotherapeutic drugs which have inherent problems like high cost, inefficacy, increasing drug resistance, and toxic side effects. Therefore, the discovery and development of new therapeutic solutions is urgently needed. Moreover, the acceptability of new drugs and delivery mechanism among the marginalized communities in which VL remains endemic is crucial, as are means of ensuring that appropriate medications are received by the people who really need them in an effective and timely manner [26]. The current drug of choice, a one-dose liposomal formulation of Amphotericin B called AmBisome is very expensive (Table-1) and also requires refrigeration [26]. Furthermore, current Covid-19 situation has highlighted the fragility of the supply chain and limited access to VL treatment. Importantly, with the decline in VL cases and lack of sustained knowledge on kala-azar in communities and among health care providers, there can be a delay between onset of symptoms, diagnosis and treatment. Therefore, awareness needs to be improved to minimize the delay in treatment which facilitates transmission of the disease.
Assay development in leishmaniasis drug discovery: a comprehensive review
Published in Expert Opinion on Drug Discovery, 2022
Bilal Zulfiqar, Vicky. M. Avery
Based on clinical symptomatology, the disease can be characterized into different forms: visceral (VL), cutaneous (CL) and muco-cutaneous (MCL), where the latter two cause tegumentary pathogenesis and are not fatal [4]. Cutaneous leishmaniasis is the most prevalent of the clinical manifestations, being a superficial infection, it causes lesion formation on the skin. These lesions can self-heal within months to years depending upon the immune status of the patient, however lesions can form permanent scars causing social stigma, isolation and psychological issues for the patients [5]. On occasion, the infections can evolve into a severe form called muco-cutaneous leishmaniasis, whereby lesions and nodules are formed around the mucosal lining (palate, pharynx, larynx and nasal areas) causing tissue destruction leading to an exaggerated inflammation throughout the region [6]. Visceral leishmaniasis is the lethal form of the disease that, if left untreated, is referred to as kala-azar in the Indian sub-continent [7]. The organs that are affected by VL include the liver, spleen and bone marrow, with pathological symptoms such as sporadic fever, cachexia, anemia, splenomegaly and hepatomegaly [8].
The preclinical discovery and development of oral miltefosine for the treatment of visceral leishmaniasis: a case history
Published in Expert Opinion on Drug Discovery, 2020
Juliana Q. Reimão, Débora P. Pita Pedro, Adriano C. Coelho
Closely associated with poverty, the leishmaniases are considered by the World Health Organization (WHO) to be a NTD, endemic in 98 countries and three territories [1], representing one of the largest disease burdens with over 2.4 million disability-adjusted life years (DALYs) and a huge impact on public healthcare [2]. To this date, the leishmaniases remain underreported, lacking simple and effective tools for case management [5]. Potentially fatal and endemic in 75 countries, VL or kala-azar is caused by Leishmania donovani (in the Indian subcontinent and Africa) and Leishmania infantum (syn. Leishmania chagasi) (in the Mediterranean basin, and Central and South America) [6]. In the last five years of data, 168,906 autochthonous human cases have been reported globally [7].