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Case 50. Leishmania donovani infection (Kala azar) (54 y-o M)
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| Liver biopsy from a Japanese worker who stayed in India, showing prolonged fever and liver dysfunction |
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Key words : Kala azar, Leishmania donovani, microgranuloma
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zoonosis
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| Microgranulomas are formed in the liver parenchyma. Diffuse activation of Kupffer cells is associated (HE). | The microgranulomas consist of activated Kupffer cells. No pathogens are discernible histologically (HE, high power). | |
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| The 1:500 diluted patien's own serum detects granular (round-shaped) pathogens in the cytoplasm of macrophages in the microgranulomas, strongly suggesting visceral leishmaniasis (indirect immunoperoxidase). The diagnosis was confirmed serologically. | Reference case 50A Autopsied liver of visceral leishmaniasis in a Kenyan adult (HE). In this case, diffuse activation of Kupffer cells is noted, but no microgranulomatous nodule formation (HE). |
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| Reference case 50A Autopsied liver of visceral leishmaniasis in a Kenyan adult (HE, oil immersion). Oil immersion observation discloses the occurrence of haloed small granules (protozoan bodies) in the cytoplasm of Kupffer cells (HE). |
Reference case 50B Stamp smear of the spleen of a Chinese boy infected with L. infantum (Giemsa). Numerous protozoan bodies are phagocytized by macrophages. L. infantum provoking systemic visceral involvement is endemic in the inland part of China. |
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