How does infection occur?
Leishmania lives in the bodies of rodents, dogs and some wild animals. The carrier is a mosquito, a small insect active at dusk and at night; its bite often goes unnoticed. The disease is not transmitted from person to person in the usual way. From the bite to the first signs of the skin form, it takes from several weeks to several months; with the visceral form, the latent period can last up to a year. This is why it is important to tell your doctor about trips out of town and abroad, even after many months.
- Source: rodents, dogs, wild animals
- The carrier is a mosquito active at dusk
- Latent period from several weeks to a year
- Not transmitted from person to person
- Visitors and children are more often infected
Skin form: what does an ulcer look like?
At the site of the bite, a dense, painless tubercle appears, which slowly grows and then opens to form an ulcer with roll-like edges and a moist bottom. The ulcer is usually located on the face, neck, arms or legs - in areas not covered by clothing. There may be several outbreaks. Healing takes several months to a year and almost always results in a noticeable scar, so early consultation with a doctor can reduce cosmetic consequences.
- A dense nodule on an open area of skin
- Gradual ulceration with raised edges
- Small pain with large size
- Enlargement of nearby lymph nodes
- Persistent retracted scar after healing
Visceral form
In visceral leishmaniasis, parasites multiply in the cells of the bone marrow, spleen and liver. The disease develops gradually: prolonged fever of the wrong type, sweating, lack of appetite, weight loss. The abdomen enlarges due to the spleen, the skin becomes pale or darkens. Hemoglobin, leukocytes and platelets in the blood decrease, which causes infections and bleeding. In young children and people with weakened immune systems, the condition worsens more quickly, and delay is dangerous.
- Prolonged fever without obvious cause
- Significant enlargement of the spleen and liver
- Decrease in hemoglobin, leukocytes and platelets
- Weight loss, swelling, weakness
- Frequent co-infections
Diagnostics
The basis of diagnosis is detection of the pathogen. In the case of the cutaneous form, a scraping or impression smear is taken from the edges of the ulcer; in the visceral form, a punctate of the bone marrow, less often the spleen or lymph node, is examined. The picture is completed by a general blood test, biochemistry, ultrasound of the abdominal organs and spleen, serological tests and PCR. The doctor must rule out other causes of prolonged fever and enlarged spleen: typhoid fever, malaria, brucellosis, tuberculosis, blood diseases.
- Microscopy of material from the edge of an ulcer
- Cytological examination of punctate
- General blood test with leukemia formula
- Biochemical blood test and protein fractions
- Ultrasound of the spleen and abdominal organs
- Serological tests and PCR as indicated
Treatment and prevention
Treatment is prescribed only by a doctor: the choice depends on the shape, number and location of lesions, age and concomitant diseases. Small skin lesions are sometimes treated locally; with multiple lesions and any visceral form, systemic antiparasitic therapy is needed in a hospital setting. Self-medication, cauterization and folk remedies delay healing and enlarge the scar. Prevention comes down to protection from mosquito bites, especially in the evening, and attention to pets.
- Local or systemic antiparasitic therapy as prescribed by a doctor
- The visceral form is treated in a hospital
- Treatment of ulcers and prevention of bacterial inflammation
- Mosquito nets on windows and above the bed
- Repellents and covered clothing at dusk
- Do not cauterize or open the ulcer yourself