Answer 19
Characteristic findings in visceral leishmaniasis (kala azar) include:
False a. eosinophilia
True b. pancytopaenia
True c. polyclonal hypergammaglobulinaemia
False d. positive leishmanin test
True e. lymphadenopathy
a. A low or normal eosinophil count would be more usual
b. Pancytopaenia is common and is due to both marrow suppression and hypersplenism
c. Hypergammaglobulinaemia: this antibody response is ineffective in clearing Leishmania and diverts immune resources from concomitant infections. Indeed most deaths are due to intercurrent infection.
d. A positive Leishmanin test indicates good cell-mediated immunity. The test is usually negative in kala azar (like the tuberculin test in miliary tuberculosis) but becomes positive after treatment.
e. Hepatosplenomegaly generally occurs before lymph node enlargement
