Kala Azar- Difficult Yet Diagnosable Entity

ABSTRACT

Kala azar also called as visceral leishmaniasis is a slowly progressive parasitic infection caused by protozoan of Leishmania genus transmitted by infected bite of female Phlebotomus.(1,2) Known endemic region of the world are rural India, Bangladesh, Sudan, Nepal and Brazil.(3) In India, kala azar is prevalent in hot and humid climates in eastern Indian states with most cases reported from Bihar, Bengal, Jharkhand and Uttar Pradesh,(4) with few sporadic cases reported from sub Himalayan part of north India including Uttarakhand, Jammu and Kashmir and Himachal Pradesh and few cases from Gujrat.(5,6,7) Diagnosis of kala azar is based on clinical suspicion of the disease along with diagnostic tests that include parasitic demonstration in splenic aspirate and amastigote form of LD (Leishmania donovani) bodies in bone marrow aspirate.(8) Splenic aspirate has a very good sensitivity index but is not generally the preferred diagnostic test because of its difficulty technique and risk of fatal haemorrhage, hence bone marrow aspirate is most commonly performed diagnostic test.