Visceral leishmaniasis - Kala-azar

It is an infectious disease caused by a protozoan of the genus Leishmania. It is also known as Kala-azar because of the grayish coloration of the skin acquired by the inhabitants of India when they contract the disease. 
It occurs mainly in India, Afghanistan, Brazil, Colombia, Iraq, Pakistan and East Africa. 

It affects humans and different animal species, especially dogs. It is transmitted by mosquito bite and the incubation period from the bite to the onset of symptoms can vary from weeks to months.
An increase of cases has been described in patients with HIV immunodeficiency.  

It manifests with fever that persists for 2 to 8 weeks, fatigue and general malaise. It may be accompanied by diarrhea, loss of appetite, muscle pain and cough. After the fever disappears, febrile fever and an increase in the size of the spleen and liver and an earthy color of the skin may remain. If treatment is not started, the clinical picture may worsen, causing a decrease in the number of blood cells leading to anemia, bleeding, lowered defenses and swelling of the skin. In severe cases, it can lead to the death of the infected person. 

Visceral Leishmania infection should be suspected when symptoms are compatible in endemic areas of the disease. A blood test should be performed for evidence of a decrease in all three cell lines (white blood cells, red blood cells and platelets). The diagnosis of security is obtained by bone marrow aspirate-puncture where the parasite is found. Another option is to perform a liver function and analysis.  

The most commonly used treatment is antimonial drugs. In cases where the patient suffers renal insufficiency, amphotericin B can be used as an alternative, with very good results. In some cases, blood transfusions may be necessary to correct the deficits resulting from the infection.