[Kala azar. Rare import and significant differential diagnosis].
After traveling into regions endemic for leishmaniasis all patients presenting with generalized febrile symptoms, pancytopenia, hepatosplenomegaly and symptoms as well as laboratory parameters also seen in autoimmune diseases should be screened for leishmaniasis even after a longer time period. Doctors should bear in mind that especially immunosuppressed patients can present with atypical and abortive symptoms and that in this group of patients immune diagnosis is unreliable. A diagnosis of a lymphoma related only to the spleen should not be made and splenectomy must not be carried out before reliable exclusion of kala azar, using modern diagnostic tools like PCR. Patients should be referred to specialized centers e.g. institutes for tropical medicine and therapy must follow actual guidelines, such as the German guidelines published by the AWMF.
Sudeck
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Sektion Tropenmedizin/Bernhard-Nocht-Ambulanz, Zentrum für Innere Medizin am Universitätsklinikum Hamburg-Eppendorf, Bernhard-Nocht-Strasse 74, 20359, Hamburg. sudeck@bni-hamburg.de
D003422:Critical Care / Q000379:methods*; D019353:Endemic Diseases / Q000517:prevention & control*; D006801:Humans; D007898:Leishmaniasis, Visceral / Q000175:diagnosis* / Q000628:therapy*; D008223:Lymphoma / Q000175:diagnosis; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians'; D035583:Rare Diseases / Q000175:diagnosis / Q000628:therapy; D014195:Travel