|KALA-AZAR OR VISCERAL LEISHMANIASIS
|What are Signs & Symptoms of PKDL?
Types of morphological lesions:
Rare manifestations of PKDL include:
- Early hypopigmented macules similar to macular lesions of Lepromatous Leprosy but normally less than 1 cm. Usually occur on face but can affect any part of the body.
- Later (after a variable period of months or years) diffuse nodular lesions on those macules
- Erythematous butterfly rash which may be aggravated by exposure to Sunlight; an early sign of PKDL
- Erythematous papules and nodules which usually occur on face, especially the chin.
- Lesions progressive over many years , seldom heal spontaneously
HIV and Kala-azar co-infection
- Multiple lesions coalesce to form larger plaque type lesions
- Verrucous lesions (hands and feet)
- Papillomatous lesions (on muzzle area of face, nose, chin, and lips)
- Hypertrophic lesions (eyelids, nose and lips)
- Xanthematous rash (orange plaque on axillary fold, cubital fossae, inner thighs, outer canthus of the eye and perioral)
- Pityriasis rosea like lesions
Details in treatment regimen and other can be seen at Minutes of the Working Group on HIV-KA
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- Visceral leishmaniasis (VL) has emerged as an opportunistic infection in HIV and other immunosuppressed patients
- More than 1000 cases of HIV and VL are reported from 25 countries. However, in India yet not a serious problem
- VL may be first Opportunistic Infection in asymptomatic HIV-I infected person
- Also occurs in advanced stage of AIDS
- All co-infected patients are not symptomatic
- Diagnosis may be altered because symptoms may be of short duration; fever and spleen may not be marked; Leishmania antibodies may be undetectable.
- However peripheral blood smears of buffycoat and blood culture may yield good results
- Response to treatment is poor; drug side effects may be more and relapses may be common