[Leish-l] burqa

[Basu Dev Pandey]

Dear All.
I have patients with fever for more than month and was positive for rk39
and Bone for LD bodies. However is not responding. Here is summary of the
cases and looking forward for your expert opinion,

--------------------------------------------------------------------------------------------------------------------------------------------------

*32 years old male patient fever for more than 1 month*

·         High TG

·         High Ferritin

·         Pancytopenia

·         BM inconclusive for

 Hemotological causes


Important: visceral leishmaniasis with brucellosis

Persistent fever with cytopeniasis

Hemophagocytic lymphohistocytosis?

   - No comorbidities
      - Loose stools x 1 year
      - Fever x 1 month
      - Cough x 1 month
   - Pallor (+)
   - Icterus  (+)
   - Hepatosplenomegaly (+)

Ø  *Test*

   - rK39 (+)
   - LD body seen in bone marrow smears (+)
   - Brucella Ab  (+)
   - PCR for Leishmania – in procress
   - TORCH panel – awaited

Ø  *Treatment*

·         LAMB 5mg/kg for 3 days given 2 week back

·         Doxycycline  and Rifampicin  continued

·         On Cortilone 40mg OD started 1 week back

However fever is persistent

Ø  *Plan:*

   - CT Chest (+), Abdomen (+), Pelvis
   - Start ATT ?
   - Hematology consultation for ruling out HLH
   - Gastroenterology & Hepatology consultation for Colonoscopy; to rule
   out any GI cause
   - Start Inj Paromomycin ?
   - Start T. Coartem  ?

------------------------------------------------------------------------------------------------------------------------------------
Regards,

Dr. Basu Dev Pandey
Director
Sukraraj Tropical and Infectious Disease Hospital
Teku, Kathmandu
Telephone: +977-1- 4216192,4268960
Email: drbasupandey at gmail.com
URL: www.stidh.gov.np




On Tue, Dec 4, 2018 at 2:24 AM Carlos Costa <chncosta at gmail.com> wrote:

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> Recently, it came up in my mind that the use of burqa might be associated
> with the protection against cutaneous leishmaniasis in the Middle-East. I
> am pretty sure that I heard from someone or read somewhere but I cannot
> recall the source.
>
> Then I asked my Prof. Ali Khamesipour, from Tehran, and to Prof. Jeff Shaw
> but they do not know anything about the subject.
>
> Finally, I entered in PubMed and found only the attached article by Al
> Aboud et al with a quote that burqa might be protective against
> leishmaniasis.
>
> The issue is quite interesting. So, I ask the colleagues who know something
> or that want to express their thought about the issue to share with our
> community.
>
> Cheers,
>
> Carlos.
>
>
> --
> Carlos H. N. Costa, MD, DSc.
> President
> Instituto de Doenças do Sertão
> *Instituto de Doenças Tropicais Natan Portella*
>
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> *64001-450 Teresina-PI*
> *Brazil*
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> +55 86 3221-3062 (W),
> +55 86 3237-1075 (H).
>
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