Malek M S, Robi I H, Islam M S, Kabir M A, Uddin M Z, Sumon S M, Siddiqui N I
Dr Md Saiful Malek, Junior Consultant Medicine, Upazilla Health Complex, Vhaluka, Mymensingh, Bangladesh; E-mail:
Mymensingh Med J. 2020 Oct;29(4):879-886.
Visceral Leishmaniasis is the most severe form of leishmaniasis and can be fatal in the absence of treatment. Mortality is very high in untreated cases 90%. Clinical case series document a 5% case fatality rate for kala-azar patients in the hospital as complication of the disease. Nepal, India, Bangladesh, Brazil and Sudan constitute five countries of the world where more than 90% of visceral leishmaniasis occurs. Mymensingh accounted for more than 50% of total kala-azar case reported in Bangladesh. This observational study was done at SKKRC under Mymensingh Medical College Hospital, Mymensingh, Bangladesh from 1st august 2013 to 28th February 2014, to find out various clinical features and hematological picture in visceral leishmaniasis. Total 100 diagnosed case of visceral leishmaniasis was taken. Among total patient male and female were nearly equally affected by kala-azar. All age group were affected by kala-azar from below 2 years to above 50 years. Poor people in the society were affected more by kala-azar. Mymensingh was the highest incidence of kala-azar among different district in Bangladesh. Pyrexia, pallor, weight loss were the main symptoms of visceral leishmaniasis. Abdominal distension, jaundice, vomiting, cough, bleeding manifestation were less frequent symptoms of kala-azar. Hepatosplenomegaly were the frequent sign of kala-azar. Majority of patient had anemia, leucopenia and thrombocytopenia. ESR was frequently raised in kala-azar patient among those patient many had high ESR more than 100 mm in 1st hour. In conclusion prolong fever, progressive pallor, anorexia, weight loss, hepatosplenomegaly in endemic area were the main clinical features of visceral leishmaniasis. Anemia, leucopenia, thrombocytopenia, bi-cytopenia, pancytopenia and high ESR were frequently found hematological pictures in visceral leishmaniasis.
内脏利什曼病是利什曼病最严重的形式,若不治疗可能会致命。未经治疗的病例死亡率非常高,达90%。临床病例系列记录显示,在医院中,黑热病患者作为该疾病的并发症,病死率为5%。尼泊尔、印度、孟加拉国、巴西和苏丹是世界上五个内脏利什曼病发病率超过90%的国家。孟加拉国迈门辛地区报告的黑热病病例占全国总数的50%以上。这项观察性研究于2013年8月1日至2014年2月28日在孟加拉国迈门辛医学院医院下属的SKKRC进行,旨在了解内脏利什曼病的各种临床特征和血液学表现。共选取了100例确诊的内脏利什曼病病例。在所有患者中,男性和女性受黑热病影响的程度几乎相同。所有年龄组,从2岁以下到50岁以上,均受到黑热病影响。社会中的贫困人口受黑热病影响更为严重。迈门辛是孟加拉国不同地区中黑热病发病率最高的地区。发热、面色苍白、体重减轻是内脏利什曼病的主要症状。腹胀、黄疸、呕吐、咳嗽、出血表现是黑热病较不常见的症状。肝脾肿大是黑热病常见的体征。大多数患者有贫血、白细胞减少和血小板减少。黑热病患者的血沉经常升高,其中许多患者在第1小时血沉超过100毫米。总之,在流行地区,持续发热、进行性面色苍白、厌食、体重减轻、肝脾肿大是内脏利什曼病的主要临床特征。贫血、白细胞减少、血小板减少、双血细胞减少、全血细胞减少和血沉升高是内脏利什曼病常见的血液学表现。