[Leish-l] burqa

Wed Dec 5 15:36:11 -02 2018

 Hi Basu,

Still with fever?
Strange, because fever in kala-azar by L. infantum usually disappears after
a week of therapy even in those that will not respond. However, I do not
know if it is the same with L. donovani.
Your plans are good, I think.

Carlos.

On Wed, 5 Dec 2018 at 12:01 Basu Dev Pandey <drbasupandey at gmail.com> wrote:

> Hi Carlos
> we tested for HIV antibody
>
> Sent from my iPad
>
> On Dec 5, 2018, at 8:21 PM, Carlos Costa <chncosta at gmail.com> wrote:
>
> Hi Basu,
>
> Have you tested for HIV? Amastigotes identification is quite specific. Are
> they abundant? Have you cultivated?
>
> Cheers,
>
> Carlos.
>
> Em ter, 4 de dez de 2018 às 03:56, Basu Dev Pandey <drbasupandey at gmail.com>
> escreveu:
>
>> 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
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>>
>
> --
> Carlos H. N. Costa, MD, DSc.
> President
> Instituto de Doenças do Sertão
> *Instituto de Doenças Tropicais Natan Portella*
>
> *Centro de Ciências da Saúde da Universidade Federal do Piauí*
> *Rua Artur de Vasconcelos 151
> <https://maps.google.com/?q=Rua+Artur+de+Vasconcelos+151&entry=gmail&source=g>-Sul*
> *64001-450 Teresina-PI*
> *Brazil*
> Telephones: +55 86 3222-4377 (W),
> +55 86 3221-3062 (W),
> +55 86 3237-1075 (H).
>
>
> Aviso: As informações contidas nesta mensagem são CONFIDENCIAIS,
> protegidas pelo sigilo legal, por direitos autorais e destinadas
> exclusivamente à pessoa ou organização para a qual a mensagem foi destinada.
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>