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Leishmaniasis

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Codey on Sep 29, 2009 Says :

Leishmania slideshow

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Slide 1 :

Leishmaniasis Leishmania donovani (complex) (VL) Leishmania tropica (CL) Leishmania major (CL) Leishmania aethiopica (CL) Leishmania mexicana (Complex) (CL) Leishmania brazilliensis (complex) (MCL) Leishmania peruriana

Slide 2 :

The Parasite Phylum Order Family Genus Sarcomastigophora Kinetoplastida Trypanosomatidae Leishmania

Slide 3 :

Morphology Promasitogte Insect Motile Midgut Amastigote Mammalian stage Non-motile Intracellular Digenetic Life Cycle

Slide 4 :

Morphology Promastigote Amastigote Flagella Kinetoplast Golgi Nucleus Cytoskeleton

Slide 5 :

Promastigote

Slide 6 :

Amastigotes (*) of Leishmania donovani in the cells of a spleen. The individual amastigotes measure approximately 1 µm in diameter.

Slide 7 :

Amastigote

Slide 8 :

Amastigotes of Leishmania in a macrophage from a lymph node of a dog.

Slide 9 :

Leishmania (Leishman-Donovan or LD bodies). Lying in macrophage cells from liver. Giemsa. ×12000. Enlarged by 9.6.

Slide 10 :

A macrophage filled with Leishmania amastigotes.

Slide 11 :

Life cycle The organism is transmitted by the bite of several species of blood-feeding sand flies (Phlebotomus) which carries the promastigote in the anterior gut and pharynx. It gains access to mononuclear phagocytes where it transform into amastogotes and divides until the infected cell ruptures. The released organisms infect other cells. The sandfly acquires the organisms during the blood meal, the amastigotes transform into flagellate promastigotes and multiply in the gut until the anterior gut and pharynx are packed. Dogs and rodents are common reservoirs.

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Mammalian Hosts Rodents Gerbils Hyraxes Bats Porcupines Opossums Sloths Primates Dogs Foxes Anteaters . . . . .

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Vectors Phlebotomine Sandflies 6 genera world wide distribution Phlebotomus & Lutzomia 500 species Females Haematophagus Males sap feeders

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Slide 16 :

Clinical Disease Visceral Fatal (90% untreated) Liver Spleen Bone marrow Cutaneous Generally Self- healing Skin Mucous membranes SPECTRUM OF DISEASE

Slide 17 :

Initial Infection Similar in all species Inoculation of promastigotes Inflammation & chemotaxis Receptor mediated phagocytosis Promastigote Amasitgote Transformation

Slide 18 :

Parasite Spread Macrophage lysis & parasite release Lymphatic spread Blood spread Target organs Skin/lymph nodes/spleen/liver/ bone marrow

Slide 19 :

Visceral Leishmaniasis 1903 1920 1931 William Leishman Pentavalent antimony Experimental transmission Leishmania donovani (Complex) L.d. archibaldi - L.d.chagasi - L.d.donovani - Ld.infantum

Slide 20 :

VL - Clinical Manifestation Variable - Incubation 3-100+ weeks Lowgrade fever Hepato-splenomegaly Bone marrow hyperplasia Anemia, Leucopenia & Cachexia Hypergammaglobulinnemia Epistaxis , Proteinuria, Hematuria

Slide 21 :

Profile view of a teenage boy suffering from visceral leishmaniasis. The boy exhibits splenomegaly, distended abdomen and severe muscle wasting.

Slide 22 :

A 12-year-old boy suffering from visceral leishmaniasis. The boy exhibits splenomegaly and severe muscle wasting.

Slide 23 :

Jaundiced hands of a visceral leishmaniasis patient.

Slide 24 :

Enlarged spleen and liver in an autopsy of an infant dying of visceral leishmaniasis.

Slide 25 :

Post Kala Azar Dermal Leishmanoid Normally develops <2 years after recovery Recrudescence Restricted to skin Rare but varies geographically

Slide 26 :

Cutaneous leishmaniasis of the face.

Slide 27 :

A cutaneous leishmaniasis lesion on the arm.

Slide 28 :

INFECTION Sub-clinical or inapparent infection Recovery Death Immune to reinfection Concurrent infection PKDL

Slide 29 :

Diagnosis Clinical signs & symptoms Hypergammaglobulinemia ELISA/Formol gel Bone marrow biopsy Spleen or liver biopsy Culture & Histology

Slide 30 :

Speciation Similar morphology Isoenzyme profiles - Zymodemes Monoclonal antibodies DNA hybridisation - PCR

Slide 31 :

Treatment Good nursing Diet Antibiotics Pentavalent antimony Pentamidine New drugs - New delivery

Slide 32 :

Control Vector control Reservoir control Treatment of active cases Vaccination

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Anemia, Leucopenia & Cachexia. Hypergammaglobulinnemia. Epistaxis , Proteinuria, Hematuria. 21. Pro more Anemia, Leucopenia & Cachexia. Hypergammaglobulinnemia. Epistaxis , Proteinuria, Hematuria. 21. Profile view of a teenage boy suffering from visceral ... less

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