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  Pathogenicity and clinical manifestations

Pathogenicity and clinical manifestations:

L.donovani generates a disease termed as Leishmaniasis. Incubation period differs from 3 to 6 months. The following clinical manifestations might be viewed.

A.  Inapparent infection:

Infection is present however the disease is absent. Skin test is positive and antibody is also present. Hepatic granuloma without disease might also be seen.

B.  Kala azar:

In some situation there is acute onset of fever 104°F, rarely two peaks in 24 hr seen. In more chronic situations no fever might be present. Characteristically marked fever with little constitutional symptoms is seen and hence patient’s ambulant Lymph nodes are moderately enlarged generally the inguinal and femoral nodes (i.e., Africa). Spleen steadily enlarges and fills right iliac fossa: primary soft and then hard. Jaundice is seen in 10 percent of cases and IgG might rise to 4 g %. Reduction in platelets and half life of RBC and RES destruction are viewed.

C.  Unusual form of visceral leishmaniasis:

Tonsilar lesion with cervical lymph node extension with severe toxic form might be seen in some situations. There is quick multiplication of organisms with necrosis and death in 4 to 6 weeks.

D.  Cutaneous leishmaniasis:

Two types of clinical diseases are seen.

(1) The first one is caused by:

L.tropica major. Single or multiple skin lesions are viewed with short incubation period. Considerable tissue reaction is viewed with little parasite in the tissue. Healing takes place within one year.

(2) The second is caused by L.tropica minor:

This causes single lesion. The incubation period is longer and slower growth of parasite is viewed. Less tissue harm is present and healing takes more than 1year.

 

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