Visceral kala-azar of Spanish origin. Apropos of a case
De Caluwé, J.P.; Lievens, P.; Trolin, C.; Heimann, R.; Delcourt, A.; Taelman, H.
Acta Clinica Belgica 43(5): 349-355
1988
ISSN/ISBN: 1784-3286 PMID: 3061269 Document Number: 312253
The observation in Brussels of a case of kala azar imported from Spain led us to the following considerations: (1) kala azar remains sometimes undiagnosed or clinically confused with malignant lymphoma or leukaemia; (2) diagnosis of kala azar must be evoked whenever medical history reveals a stay in endemic regions; in this respect, clinicians must be aware that kala azar is endemic in all the Mediterranean area, including southern France; (3) for the last 15 years, in most of the Mediterranean countries, kala azar seems to occur at least as frequently in adults as in children; (4) the clinical expression of the disease may be mild at the beginning : splenomegaly may be discrete, hypergammaglobulinaemia may be lacking; (5) definite diagnosis is based on the discovery of the parasite; bone marrow aspiration represents the safest and simplest diagnostic procedure; (6) the discrepancy in frequency of subclinical and full-blown forms of infection by Leishmania donovani raises a fundamental question, not completely resolved at the present time : does a latent immunodeficient state favour the development of severe forms of kala azar ?