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    Leishmaniasis, A Simple Guide To The Condition, Diagnosis, Treatment And Related Conditions
    Leishmaniasis, A Simple Guide To The Condition, Diagnosis, Treatment And Related Conditions
    Leishmaniasis, A Simple Guide To The Condition, Diagnosis, Treatment And Related Conditions
    Ebook134 pages1 hour

    Leishmaniasis, A Simple Guide To The Condition, Diagnosis, Treatment And Related Conditions

    By Kenneth Kee

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    About this ebook

    This book describes Leishmaniasis, Diagnosis and Treatment and Related Diseases
    Leishmaniasis is a parasitic infection caused by a trypanosomatid protozoan named Leishmania, a one-celled organism.
    There are 3 different forms of Leishmaniasis:
    1.Cutaneous - affects the skin
    2.Mucocutaneous - affects the skin and mucous membranes
    3.Visceral (Systemic) - affects the entire body
    21 species of the protozoa are believed to cause disease in humans.
    The main hosts are vertebrates – often humans, rodents, canids and hyraxes.
    The disease is transmitted by the bite of infected female phlebotomine sand-flies
    A life cycle diagram taken from Wikipedia shows the transmission of the protozoan Leishmania from the sandfly to human.
    Only the female sand-fly (Phlebotomus in the Old World and Lutzomyia in the New World) spreads the protozoan through its bite.
    The flagellated promastigotes are passed out through a bite (1000 parasites per bite) into the blood of the human or animal some of the flagellates are killed while others go into the intracellular lysosomal organelles of macrophages of the reticuloendothelial system, where they drop their flagella and transform into the amastigote form.
    The amastigote forms also proliferate by binary fission, with multiplication persisting until the macrophagel is filled with the parasites and bursts, freeing the amastigotes into the circulation.
    The free amastigotes then attack fresh cells, thus replicating the cycle and, in the process, infecting the complete reticuloendothelial system.
    Some of the free amastigotes are sucked by the sand-fly during its blood meal, finishing the cycle.
    Dependent on the species of parasite and the host’s immune status, the parasites may grow for weeks to months before manifesting as skin lesions or as a disseminated systemic infection affecting the liver, spleen, and bone marrow.
    Infections may recover spontaneously or may go on to chronic disease, often causing death from secondary infection.
    Cases of leishmaniasis have been documented on all continents except Australia and Antarctica.
    Symptoms:
    1.Night sweats weakness and anorexia, which are typical.
    2.Fever.
    3.Weight loss.
    4.Hepatomegaly (can be marked).
    5.Splenomegaly (often enormous).
    6.Anemia and pancytopenia (can cause death from hemorrhage or infection).
    7.Hyper-gammaglobulinemia.
    8.Dark pigmentation of the skin is infrequent but the name kala azar is Hindi for black fever.
    Diagnosis:
    Tests that may be done to diagnose the disorder are:
    1.Biopsy of the spleen and culture
    2.Bone marrow biopsy and culture
    3.Direct agglutination assay
    4.Indirect immunofluorescent antibody test
    5.Leishmania-specific PCR test
    6.Liver biopsy and culture
    7.Lymph node biopsy and culture
    8.Montenegro skin test (not approved in the United States)
    9.Skin biopsy and culture
    Treatment:
    Leishmaniasis is a treatable disease that can be cured.
    The treatment is dependent upon type of disease, parasite species and geographical site.
    In VL the prognosis is so much poorer so treatment is required.
    For VL, new medications, switching of treatment, and the possibility for combinations of reputable drugs have improved treatment in India, but not in East Africa.
    In the CL types that recover by itself the question is whether any treatment should be given, particularly as treatment can be quite toxic.
    New World (West) CL may go on to mucocutaneous disease and so should be sufficiently treated.
    Old World (East) CL may be left alone or treated if lesions take a longer time to recover or disfiguring
    Medicines with antimony-containing compounds are the main drugs utilized to treat leishmaniasis.
    New drugs that may be used are:
    1.Amphotericin B
    2.Miltefosine
    3.Paromomycin
    4.Pentamidine

    TABLE OF CONTENT
    Introduction
    Chapter 1 Leishmaniasis
    Chapt

    LanguageEnglish
    PublisherKenneth Kee
    Release dateJan 24, 2019
    ISBN9780463460313
    Leishmaniasis, A Simple Guide To The Condition, Diagnosis, Treatment And Related Conditions
    Author

    Kenneth Kee

    Medical doctor since 1972.Started Kee Clinic in 1974 at 15 Holland Dr #03-102, relocated to 36 Holland Dr #01-10 in 2009.Did my M.Sc (Health Management ) in 1991 and Ph.D (Healthcare Administration) in 1993.Dr Kenneth Kee is still working as a family doctor at the age of 74However he has reduced his consultation hours to 3 hours in the morning and 2 hours inthe afternoon.He first started writing free blogs on medical disorders seen in the clinic in 2007 on http://kennethkee.blogspot.com.His purpose in writing these simple guides was for the health education of his patients which is also his dissertation for his Ph.D (Healthcare Administration). He then wrote an autobiography account of his journey as a medical student to family doctor on his other blog http://afamilydoctorstale.blogspot.comThis autobiography account “A Family Doctor’s Tale” was combined with his early “A Simple Guide to Medical Disorders” into a new Wordpress Blog “A Family Doctor’s Tale” on http://ken-med.com.From which many free articles from the blog was taken and put together into 1000 eBooks.He apologized for typos and spelling mistakes in his earlier books.He will endeavor to improve the writing in futures.Some people have complained that the simple guides are too simple.For their information they are made simple in order to educate the patients.The later books go into more details of medical disorders.He has published 1000 eBooks on various subjects on health, 1 autobiography of his medical journey, another on the autobiography of a Cancer survivor, 2 children stories and one how to study for his nephew and grand-daughter.The purpose of these simple guides is to educate patient on health disorders and not meant as textbooks.He does not do any night duty since 2000 ever since Dr Tan had his second stroke.His clinic is now relocated to the Buona Vista Community Centre.The 2 units of his original clinic are being demolished to make way for a new Shopping Mall.He is now doing some blogging and internet surfing (bulletin boards since the 1980's) startingwith the Apple computer and going to PC.The entire PC is upgraded by himself from XT to the present Pentium duo core.The present Intel i7 CPU is out of reach at the moment because the CPU is still expensive.He is also into DIY changing his own toilet cistern and other electric appliance.His hunger for knowledge has not abated and he is a lifelong learner.The children have all grown up and there are 2 grandchildren who are even more technically advanced than the grandfather where mobile phones are concerned.This book is taken from some of the many articles in his blog (now with 740 posts) A Family Doctor’s Tale.Dr Kee is the author of:"A Family Doctor's Tale""Life Lessons Learned From The Study And Practice Of Medicine""Case Notes From A Family Doctor"

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      Book preview

      Leishmaniasis, A Simple Guide To The Condition, Diagnosis, Treatment And Related Conditions - Kenneth Kee

      Leishmaniasis,

      A

      Simple

      Guide

      To

      The Condition,

      Diagnosis,

      Treatment

      And

      Related Conditions

      By

      Dr Kenneth Kee

      M.B.,B.S. (Singapore)

      Ph.D (Healthcare Administration)

      Copyright Kenneth Kee 2019 Smashwords Edition

      Published by Kenneth Kee at Smashwords.com

      Dedication

      This book is dedicated

      To my wife Dorothy

      And my children

      Carolyn, Grace

      And Kelvin

      This book describes Leishmaniasis, Diagnosis and Treatment and Related Diseases which is seen in some of my patients in my Family Clinic.

      (What You Need to Treat Leishmaniasis)

      This eBook is licensed for your personal enjoyment only. This eBook may not be re-sold or given away to other people. If you would like to share this book with another person, please purchase an additional copy for each reader.

      If you’re reading this book and did not purchase it, or it was not purchased for your use only, then please return to Smashwords.com and purchase your own copy.

      Thank you for respecting the hard work of this author.

      Introduction

      I have been writing medical articles for my blog: http://kennethkee.blogspot.com (A Simple Guide to Medical Disorder) for the benefit of my patients since 2007.

      My purpose in writing these simple guides was for the health education of my patients.

      Health Education was also my dissertation for my Ph.D (Healthcare Administration).

      I then wrote an autobiolographical account of his journey as a medical student to family doctor on his other blog: http://afamilydoctorstale.blogspot.com.

      This autobiolographical account A Family Doctor’s Tale was combined with my early A Simple Guide to Medical Disorders into a new Wordpress Blog A Family Doctor’s Tale on http://kenkee481.wordpress.com.

      From which many free articles from the blog was taken and put together into 800 eBooks.

      Some people have complained that the simple guides are too simple.

      For their information they are made simple in order to educate the patients.

      The later books go into more details of medical disorders.

      The first chapter is always from my earlier blogs which unfortunately tends to have typos and spelling mistakes.

      Since 2013, I have tried to improve my spelling and writing.

      As I tried to bring the patient the latest information about a disorder or illness by reading the latest journals both online and offline, I find that I am learning more and improving on my own medical knowledge in diagnosis and treatment for my patients.

      Just by writing all these simple guides I find that I have learned a lot from your reviews (good or bad), criticism and advice.

      I am sorry for the repetitions in these simple guides as the second chapters onwards have new information as compared to my first chapter taken from my blog.

      I also find repetition definitely help me and maybe some readers to remember the facts in the books more easily.

      I apologize if these repetitions are irritating to some readers.

      Chapter 1

      Leishmaniasis

      What is Leishmaniasis?

      Leishmaniasis is a parasitic infection caused by a trypanosomatid protozoan named Leishmania.

      Protozoa are one-celled organisms.

      There are 3 different forms of Leishmaniasis:

      1. Cutaneous - affects the skin

      2. Mucocutaneous - affects the skin and mucous membranes

      3. Visceral (Systemic) - affects the entire body

      21 species of the protozoa are believed to cause disease in humans.

      The main hosts are vertebrates – often humans, rodents, canids and hyraxes.

      The disease is transmitted by the bite of infected female phlebotomine sand-flies.

      More than 90 of the 1,000 or so sand-fly species are diagnosed to transmit the disease.

      The protozoa grow in the insect vector and are then inoculated into another mammalian recipient, probably a human.

      There it is engulfed up by macrophages but may live and even replicate inside them.

      The cutaneous form presents with skin ulcers

      Skin ulcer From Wikipedia

      The mucocutaneous form presents with ulcers of the skin and also the mucous membranes of the mouth and nose.

      The visceral form is more extensive, mainly in the reticuloendothelial system.

      Incidence

      The incidence of leishmaniasis is affected by:

      1. The features of the parasite species.

      2. The local ecological features of the transmission sites.

      3. Present and past exposure of the human population to the parasite.

      An evaluated 1 million new cases a year of cutaneous and mucocutaneous leishmaniasis happen

      The disease affects the poorest people on the planet and is related with malnutrition, population displacement, poor housing, a weak immune system and lack of resources.

      More than 12 million people in 88 countries are thought to be infected but many cases are asymptomatic.

      The male to female ratio is about 2:1, may be due to higher exposure of women to places where there is a risk of sand-fly bites.

      Cases of leishmaniasis have been documented on all continents except Australia and Antarctica.

      In the Americas, leishmaniasis can be present in Mexico and South America.

      Leishmaniasis has been documented in military personnel returning from the Persian Gulf.

      The most frequent involved areas are the Mediterranean, India, Bangladesh, Brazil and Sudan.

      Southeast Asia

      VL is the main type, and spread is mainly in low-altitude rural areas (<600 m above sea level) with high rainfall and humidity, temperature range 15-38°C, abundant vegetation, subsoil water and alluvial soil.

      It is most frequent in farming villages where houses have mud walls and earthen floors and cattle and humans live in close proximity.

      India

      5-10% of VL patients in the Indian subcontinent form post-kala azar dermal leishmaniasis (PKDL), a macular, papular or nodular rash happening 6-12 months after the infection is clearly healed, and probably indicating repeated infectiousness.

      East Africa

      VL is more frequent in Northern savannah and forest areas where sandflies live around termite mounds.

      Cutaneous leishmaniasis (CL) happens in the Ethiopian highlands, and in areas of East Africa where villages built are on riverbanks or rocky outcrops which are the habitat of hyraxes.

      Over 50% of VL patients in East Africa form post-kala azar dermal leishmaniasis (PKDL), a macular, papular or nodular rash

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