Diagnosis of Leishmaniasis (Kala-Azar)
Diagnosis of leishmaniasis follows elicitation of a detailed history, especially details about a recent travel, and physical examination. The symptoms are enquired into.
Samples of affected tissue are examined for the parasite under a microscope, in cultures, and through other means. A biopsy sample and aspirate is obtained from the margin of the skin lesion, spleen or bone marrow and the sample is spread on a slide and stained with Leishman's or Giemsa's stain (pH 7.2) for about 20 minutes. It is then visualized for Leishman-Donovan bodies or amastigotes. Amastigotes are small, round bodies 2-4ìm in diameter with indistinct cytoplasm, a nucleus and a small rod-shaped kinetoplast.
The leishmanin skin test, also known as the Montenegro test is widely used in some areas.
Blood tests are performed also to detect antibody (an immune response) to the parasite. This is helpful in diagnosing visceral leishmaniasis. Massively enlarged spleen and liver are hallmarks of a classic case of visceral leishmaniasis.
It should be noted that laboratory tests may even be negative in a person with leishmaniasis.
