Misdiagnosis and Mistreatment of Post-Kala-Azar Dermal Leishmaniasis

Misdiagnosis and Mistreatment of Post-Kala-Azar Dermal Leishmaniasis

Post-kala-azar dermal leishmaniasis (PKDL) is a known complication of visceral leishmaniasis (VL) caused by L. donovani. It is rare in VL caused by L. infantum and L. chagasi. In Sudan, it occurs with a frequency of 58% among successfully treated VL patients. In the majority of cases, PKDL can be di...

Full description

Saved in:
Bibliographic Details
Published in:Case Reports in Medicine Vol. 2013; no. 2013; pp. 329 - 334-083
Main Authors: El Hassan, Ahmed Mohamed, Khalil, Eltahir Awad Gasim, Elamin, Waleed Mohamed, El Hassan, Lamyaa Ahmed Mohamed, Ahmed, Mogtaba Elsaman, Musa, Ahmed Mudawi
Format: Journal Article
Language:English
Published: Cairo, Egypt Hindawi Limiteds 01-01-2013
Hindawi Puplishing Corporation
Hindawi Publishing Corporation
John Wiley & Sons, Inc
Hindawi Limited
Subjects:
Antigens
Biopsy
Care and treatment
Case Report
Case studies
Causes of
Colleges & universities
Complications and side effects
Cytotoxicity
Deoxyribonucleic acid
Diagnosis
DNA
Health aspects
Hematology
Infections
Leishmaniasis
Lymphatic system
Lymphocytes
Parasites
Parasitic diseases
Patients
Tropical diseases
Sudan
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Post-kala-azar dermal leishmaniasis (PKDL) is a known complication of visceral leishmaniasis (VL) caused by L. donovani. It is rare in VL caused by L. infantum and L. chagasi. In Sudan, it occurs with a frequency of 58% among successfully treated VL patients. In the majority of cases, PKDL can be diagnosed on the basis of clinical appearance, distribution of the lesions, and past history of treated VL. The ideal diagnostic method is to demonstrate the parasite in smears, by culture or PCR. Diagnosis is particularly difficult in patients who develop PKDL in the absence of previous history of visceral leishmaniasis. We describe a case of cutaneous leishmaniasis misdiagnosed as PKDL and 3 cases of PKDL who were either misdiagnosed or mistreated as other dermatoses. This caused exacerbation of their disease leading to high parasite loads in the lesions and dissemination to internal organs in one of the patients, who was also diabetic. The latter patient had L. major infection. A fourth patient with papulonodular lesions on the face and arms of 17-year duration and who was misdiagnosed as having PKDL is also described. He turned out to have cutaneous leishmaniasis due to L. major. Fortunately, he was not treated with steroids. He was cured with intravenous sodium stibogluconate.
Bibliography:ObjectType-Article-1
SourceType-Scholarly Journals-1
ObjectType-Feature-2
content type line 23
Academic Editor: A. Chow
ISSN:1687-9627
1687-9635
DOI:10.1155/2013/351579