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Other Clinical Forms Emerge in Sri Lanka
Published in Yamuna Deepani Siriwardana, Leishmaniasis in Sri Lanka, 2023
Patients suspected of having visceral leishmaniasis (n = 120) fulfilling at least two of six criteria (fever >2 weeks, weight loss, tiredness affecting daily functions, splenomegaly, hepatomegaly, and anemia) were studied using clinico-epidemiological, immunological, and haematological parameters in our network for active surveillance of visceral leishmaniasis. Few more cases of visceral leishmaniasis were detected during the subsequent years through this activity. The first formal records on follow-up of visceral leishmaniasis patients were made available in this study (Siriwardana et al., 2017). This report described seven cases; four progressive treated cases (group A) and three nonprogressive, potentially asymptomatic, and observed only (group B) cases. Clinical cases were treated with systemic sodium stibogluconate, amphotericin B, or miltefosine, and all patients were followed up at the leishmaniasis clinic of the University of Colombo for 3 years, with the 2005 case followed up for 9 years (and 15 years as at present).
Antiprotozoal Effects of Wild Plants
Published in Mahendra Rai, Shandesh Bhattarai, Chistiane M. Feitosa, Ethnopharmacology of Wild Plants, 2021
Muhammad Subbayyal Akram, Rao Zahid Abbas, José L. Martinez
Mucocutaneous leishmaniasis is characterized by severe invasive infection of nasopharyngeal mucosa, while cutaneous leishmaniasis is associated with skin ulcers. In visceral leishmaniasis, host show symptoms of fever, enlargement of the liver, weight loss, swelling of the spleen and decreased blood count. The treatment of leishmaniasis depends on immune status, clinical signs and the geographical location of a host. Usually, visceral leishmaniasis and severe cases of mucocutaneous and cutaneous leishmaniasis are treated with liposomal amphotericin B and in developed countries, drugs like miltefosine, paromomycin and pentavalent antimony are used for its treatment. These drugs are unaffordable due to their very high cost and show severe side effects, including renal insufficiency. So, many patients stop their doses during treatment which results in the development of drug-resistant strains (WHO 2016).
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).
The management of Babesia, amoeba and other zoonotic diseases provoked by protozoa
Published in Expert Opinion on Therapeutic Patents, 2023
Clemente Capasso, Claudiu T. Supuran
Leishmania spp. have straightforward life cycles that require a mammalian host and a vector stage. Phlebotomine sandflies spread the parasite Leishmania in the Americas, while the genus Phlebotomus is involved in the other parts of the world [121]. Sandflies become infected by feeding on hosts with active skin lesions of cutaneous leishmaniasis or with high parasitemia in the case of visceral leishmaniasis. Parasites become promastigotes in the sandfly midgut and multiply in 4–14 days [121]. These promastigotes travel to the salivary glands, become infectious metacyclic promastigotes, and await feeding. Sandflies inject infective promastigotes into susceptible mammals during eating. Resident phagocytes phagocytize promastigotes, which become tissue-stage amastigotes and divide in a parasitophorous vacuole. The amastigotes impede phagosome acidification, allowing them to persist within phagocytes. Depending on host and parasite parameters, the parasite infects more phagocytic cells at the site of cutaneous infection or in secondary lymphoid organs, causing parasitemia [121]. Leishmania species can stay hidden from the host immune system for years using their own special set of virulence mechanisms. Preventing the spread of the disease via sandflies is a top priority. Transmission can be considerably reduced if people stay inside between dark and dawn when sandflies are most active [122]. Topical insect repellents, bed nets, and clothing coated with permethrin are also efficient at keeping sandflies at bay. Residual household sprays have been used to minimize the prevalence of vectors in residential areas [122].
Visceral leishmaniasis (kala-azar) caused by L. mexicana in a patient with AIDS
Published in Baylor University Medical Center Proceedings, 2023
Kacie L. Mitchell, Matt C. Smithhart, Bill R. Covington, Timothy M. Byrd, Seth J. Sullivan, Michael K. Dixon
Twenty known species of Leishmania are capable of causing leishmaniasis, a parasitic disease transmitted by the female sand fly. The severity of the disease typically ranges from self-limiting to life threatening depending on the species. The global incidence of visceral leishmaniasis (VL) is estimated to be between 50,000 and 90,000, with the majority of these cases occurring in endemic countries such as South America, Africa, and Asia.1 VL is typically caused by L. donovani and L. infantum, while other species, such as L. mexicana, manifest as cutaneous leishmaniasis. L. mexicana is endemic to the US, with most cases occurring in Texas.2 Interestingly, a dermatotropic species may visceralize to cause VL, especially if a patient is immunocompromised, but existing literature has not demonstrated L. mexicana undergoing this transformation.3 Furthermore, patients with HIV have been shown to have an increased risk for developing VL and have a greater likelihood of relapse.4 Standard treatment may not be curative in patients with active HIV infection.3,5
Nanoparticles for antiparasitic drug delivery
Published in Drug Delivery, 2019
Yuzhu Sun, Dongmei Chen, Yuanhu Pan, Wei Qu, Haihong Hao, Xu Wang, Zhenli Liu, Shuyu Xie
Liposomes are closed vesicles comprised of one or more lipid bilayers containing drugs in the bilayer and inner. Liposomes were firstly discovered and named by Bangham et al., 1965, and then firstly developed as a drug carrier by Gregoriadis et al. in the 1970s (Gregoriadis et al., 1974). As nanocarriers, liposomes have the advantages of targeting, controlling release and reducing toxicity. The latest report on the treatment of resistant visceral leishmaniasis with interferon gamma in combination with liposomal amphotericin B and allopurinol had no side effects and accelerated recovery (Khodabandeh et al., 2019). This report describes the first case of visceral leishmaniasis resistant to pentavalent antimonials and also the first use of combinational therapy in Iran. In recent years, it has been gradually applied to antiparasitic drugs. For example, the liposomal praziquantel and avermectin were reported to show better deworming effects (Mourão et al., 2005; She et al., 2010).