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[Kala-azar acquired in Croatia]
H Wenzl1, W Petritsch, M Decrinis
1Medizinische Klinik, Karl-Franzens-Universität, Graz.
Wiener Klinische Wochenschrift
|January 1, 1992
Summary
Kala-azar, a form of leishmaniasis, can be diagnosed using serological tests even with negative bone marrow biopsies. Prompt treatment with pentostam leads to full recovery, highlighting the importance of considering this disease in returning travelers.
Area of Science:
- Infectious Diseases
- Tropical Medicine
- Medical Diagnostics
Background:
- Leishmaniasis, particularly visceral leishmaniasis (kala-azar), is a significant health concern in Mediterranean regions.
- Travelers returning from endemic areas may present with non-specific symptoms, complicating early diagnosis.
Observation:
- A 52-year-old patient returning from Croatia presented with fever, headache, loss of appetite, weight loss, and splenomegaly.
- Initial laboratory findings included pancytopenia, prolonged prothrombin time, and elevated LDH, with negative bone marrow biopsies for leishmaniasis.
Findings:
- High antibody titers against leishmania antigen, confirmed by indirect immunofluorescent antibody test (1:128) and haemagglutination-inhibition test (1:512), led to the diagnosis of kala-azar.
- Treatment with pentostam resulted in rapid fever reduction and complete patient recovery, with a significant decrease in antibody titers post-treatment.
Implications:
- Leishmaniasis should be considered in the differential diagnosis of fever of unknown origin in patients with travel history to Mediterranean countries.
- Serological testing is crucial for diagnosing leishmaniasis, even when bone marrow biopsies are inconclusive.
- Early diagnosis and effective treatment, such as with pentostam, are vital to prevent potentially fatal outcomes of untreated leishmaniasis.