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Post-Kala-Azar Dermal Leishmaniasis — SCE Infectious Diseases MCQ

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HardTropical & Imported InfectionsPost-Kala-Azar Dermal LeishmaniasisSCE Infectious Diseases

A 40-year-old man presents with fever, pancytopenia, and hepatosplenomegaly. He has recently returned from a prolonged trip to Bihar, India. Bone marrow aspirate shows intracellular amastigotes (Leishman-Donovan bodies) within macrophages. Leishmania serology is positive. Following treatment with Liposomal Amphotericin B, he improves. What long-term complication should be monitored?

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Correct answer: E — Post-kala-azar dermal leishmaniasis (PKDL) — hypopigmented or nodular skin lesions appearing weeks to months after VL treatment

Post-kala-azar dermal leishmaniasis (PKDL) is a dermatological complication occurring weeks to years after treatment for visceral leishmaniasis (VL). It presents as macular, papular, or nodular skin lesions, particularly in East Africa and the Indian subcontinent. PKDL patients serve as a reservoir for Leishmania transmission. Treatment is with prolonged courses of Liposomal Amphotericin B or Miltefosine. Patients should be counselled about this risk at discharge.

Reference: WHO 2022 – Leishmaniasis guidelines; NICE CKS 2024 – Leishmaniasis