Clinical forms of the leishmaniases

Visceral leishmaniasis

© Dr Alvar Ezquerra, Jorge/WHO NTD

Visceral leishmaniasis, also known as kala-azar, is characterized by irregular bouts of fever, substantial weight loss, swelling of the spleen and liver, and anaemia (which may be serious).

If the disease is not treated, the fatality rate in developing countries can be as high as 100% within 2 years.

Post-kala-azar dermal leishmaniasis (PKDL)
© Dr Alvar Ezquerra, Jorge/WHO NTD

Post-kala-azar dermal leishmaniasis (PKDL) is a complication of visceral leishmaniasis (VL) in areas where Leishmania donovani is endemic; it is characterized by a hypopigmented macular, maculopapular, and nodular rash usually in patients who have recovered from VL . It usually appears 6 months to 1 or more years after apparent cure of of the disease but may occur earlier or even concurrently with visceral leishmaniasis especially in the Sudan.

PKDL heals spontaneously in the majority of cases in Africa but rarely in patients in India. It is considered to have an important role in maintaining and contributing to transmission of the disease particularly in interepidemic periods of VL, acting as a reservoir for parasites.