Leishmaniasis - PowerPoint PPT Presentation

About This Presentation
Title:

Leishmaniasis

Description:

this is about Leishmaniasis – PowerPoint PPT presentation

Number of Views:912
Slides: 27
Provided by: nasirk
Tags:

less

Transcript and Presenter's Notes

Title: Leishmaniasis


1
Leishmaniasis
2
Leishmaniasis
  • Leishmania parasites cause cutaneous,
    mucocutaneous and visceral (kala-azar)
    leishmaniasis. There are about 10 million cases
    of cutaneous leishmaniasis and 400,000 cases of
    visceral leishmaniasis per year.

3
Visceral leishmaniasis
  • Is caused by
  • L. donovani,
  • L. infantum
  • L. changasi
  • the letter two species are indistinguishable. It
    is widespread (including the mediterranean) but
    90of cases occur in north east India,
    Bangladesh, Sudan, Ethiopia, Kenya or Brazil

4
Cutaneous leishmaniasis
  • Is caused by several species.
  • L. tropica causes anthroponotic disease in urban
    areas.
  • L. major causes zoonotic disease in rural areas.
  • L. aethiopica causes cutaneous leishmaniasis in
    Ethiopia and parts on Kenya.

5
  • The L. mexican complex (L. m. mexicana, L. m.
    amazonensis, L. m. venezuelensis)
  • and the L. braziliensis complex (L. b.
    braziliensis, L. b. panamensis, L.b. guyanensis,
    L. b. peruviana)
  • cause cutaneous leishmaniasis in the Americas.
  • L. Infantum causes small numbers of cases in
    Europe.

6
  • Sand fly bite in an endemic area.
  • Visceral leishmaniasis irregular fever,
    progressive hepatosplenomegaly, pancytopenia,
    wasting.
  • Cutaneous leishmaniasis chronic, painless, moist
    ulcers or dry nodules.
  • Mucocutaneous leishmaniasis destructive
    nasopharyngeal lesions.
  • Amastigotes in macrophages in aspirates, touch
    preparations, or biopsies.
  • Positive culture, serologic tests, PCR, or skin
    test.

7
General Considerations
  • Leishmaniasis is a zoonosis transmitted by bites
    of sand flies of the genus Lutzomyia in the
    Americas and Phlebotomus elsewhere.

8
  • Visceral leishmaniasis  (kala azar) is caused
    mainly by Leishmania donovani in the Indian
    subcontinent and East Africa Leishmania infantum
    in the Mediterranean, Middle East, China, parts
    of Asia, and Horn of Africa and Leishmania
    chagasi in South and Central America.

9
  • Old World cutaneous leishmaniasis
  • is caused mainly by Leishmania tropica,
    Leishmania major, and Leishmania aethiopica in
    the Mediterranean, Middle East, Africa, Central
    Asia, and Indian subcontinent.

10
Clinical Findings
  • A. Symptoms and Signs
  • 1. Visceral Leishmaniasis (Kala azar)
  • Most infections are subclinical, but a small
    number progress to full-blown disease. A local
    nonulcerating nodule at the site of the sand fly
    bite may precede systemic manifestations but
    usually is inapparent.

11
2. Old world the new world cutaneous
leishmaniasis
  • Cutaneous swelling appear 2 week to several
    months after sand fly bites and can be single or
    multiple.
  • 3. Mucocutaneous Leishmaniasis (Espundia)
  • In Latin America, mucosal lesions develop in a
    small percentage of persons infected with L
    braziliensis and some other species, usually
    months to years after resolution of a cutaneous
    lesion.

12
  • 4. Infections in Patients with AIDS
  • Leishmaniasis is an opportunistic infection in
    persons with AIDS seen in southern Europe and
    other areas.

13
B. Laboratory Findings
  • Identifying parasites in tissue samples or
    culture material provides a definitive diagnosis.
    In visceral leishmaniasis, fine-needle aspiration
    of the spleen for culture and tissue evaluation
    is generally safe, and yields a diagnosis in over
    95 of cases.

14
Treatment
  • Treatment is not adequate because most drugs are
    quite toxic, require long courses, and are mostly
    administered parenterally.
  • A. Visceral Leishmaniasis
  • The treatment of choice for visceral
    leishmaniasis is liposomal amphotericin B, which
    is generally effective and well tolerated but
    very expensive.

15
B. Cutaneous Leishmaniasis
  • In the Old World, cutaneous leishmaniasis is
    generally self-healing over some months and does
    not metastasize to the mucosa, so it may be
    justified to withhold treatment in regions
    without mucocutaneous disease if lesions are
    small and cosmetically unimportant.

16
C. Mucocutaneous Leishmaniasis
  • Cutaneous infections from regions where parasites
    include those that cause mucocutaneous disease
    (eg, L braziliensis in parts of Latin America)
    should all be treated to help prevent disease
    progression.

17
Prevention Control
  • Personal protection measures for avoidance of
    sand fly bites include use of insect repellants,
    fine-mesh insect netting, long sleeves and pants,
    and avoidance of warm shaded areas where flies
    are common.

18
(No Transcript)
19
(No Transcript)
20
(No Transcript)
21
(No Transcript)
22
(No Transcript)
23
(No Transcript)
24
(No Transcript)
25
(No Transcript)
26
  • Thanks
Write a Comment
User Comments (0)
About PowerShow.com