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*same as Kala-azar
**Latin "black fever"
*incubation 3 weeks to >years*symptoms**fever-generally low grade**weight loss**hepatosplenomegaly- extremely substantial***completely subsides rapidly by treatment**cough, diarrhea**anemia, leukopenia, thrombocytopenia
*many patients are asymptomatic and cured spontaneously
**cell-mediated immunity
*importance of accurate diagnosis
**clinical features of VL resemble
*DDx
**chronic malaria
**schistosomiasis
**typhoid
**tuberculosis - splenomegaly is rare unless miliary TB
**hematological malignancy
*can be verically transmitted - rare
*Treatment
**to reduce parasite burden
**to improve complication
**to help to induce cell-mediated immunity
*Tx in India
**liposomal AMPH-B
***+miltefosine
***+paromomycin
***+
**AMPH-B - adherence is diffucult
**miltefosine - adherence is diffucult; now is only for combination with liposomal AMPH-B
**drug interactions
*Tx in East Africa
**
*Tx for ''L. infantum'' in Latin America
**
====post kala-azar dermal leishmanisis (PKDL)====
