What is the insect vector for leishmania?
- Sandfly
Inside the human host, which cells do the parasites replicate within?
- Phagocytic cells:
- Macrophages
- Neutrophils
- Monocytes
What are the two forms of leishmania and how are they different?
- Promastigotes – found in the sandfly – they have a flagellum and they are motile
- Amastigotes – found within humans/other vertebrate hosts – they have resorbed their flagellum and are no longer motile – found in macrophages
Which gender of sandflies takes blood meals?
- Females – need blood to provide nutrition for eggs
What are the four major forms of leishmaniasis?
- Visceral Leishmaniasis
- Cutaneous Leishmaniasis
- Diffuse Cutaneous Leishmaniasis
- Mucocutaneous Leishmaniasis
What is another name for visceral leishmaniasis?
- Kala Azar (black fever)
What are the features of visceral leishmaniasis?
- Irregular fever
- Weight loss
- Enlarged liver and spleen
- Anaemia
What are some risk factors for visceral leishmaniasis?
- Malnutrition
- Immunosuppression (e.g. because of drugs)
- HIV
Which type of leishmania causes the majority of cases of visceral leishmaniasis in Ethiopia?
- L. donovani
How is visceral leishmaniasis diagnosed?
- Visualisation of the amastigote parasite by microscopic examination of aspirates
- Antibody detection (direct agglutination test - DAT)
What are the treatment options for visceral leishmaniasis?
- Sodium stibogluconate or meglumin antimoniate
- Liposomal amphotericin B
What other clinical manifestation of leishmania can occur during or after treatment for visceral leishmaniasis?
- Post Kala-azar Dermal Leishmaniasis (PKDL)
Describe the features of local cutaneous leishmaniasis
- Heals spontaneously
- Immunity from reinfection
- NOTE: it can still leave disfiguring scars
Describe the features of diffused cutaneous leishmaniasis
- Disseminated lesions
- Resembles leprosy
- No spontaneous healing
- Difficult to treat
- Frequent relapses
1) Which part of the body does mucocutaneous leishmaniasis typically affect?
2) Describe the features of mucocutaneous leishmaniasis
1)
- Mouth and nose
2)
- Disfiguring
- Destroys mucous membrane
- No spontaneous healing
- Frequent relapses
What type of leishmania are the majority of cutaneous leishmaniasis lesions caused by?
- L. aethiopica