Kala-azar--a case series from non endemic area, Uttarakhand

Resurgence of kala azar in India has posed many problems. Apart from endemic areas, cases are being reported from non-endemic area. Other than diagnostic difficulties, resistance to stibogluconate & relapses are common problem in sporadic visceral leishmaniasis (VL). We present one case in detail & give brief description of nine other cases, hailing from non-endemic area, Uttarakhand, during the period from December 2005 to September 2011, diagnosed in our teaching hospital. The patients in our study were diagnosed as VL by clinical findings and confirmed by demonstration of LD bodies in splenic or bone marrow smears. Six cases were treated successfully with amphotericin. One case died during treatment and three cases lost the follow up. Clinician should suspect and investigate for VL in patients with pyrexia of unknown origin even when the disease is not endemic in a specific region for early diagnosis.