MCQ – 65814

A patient presented with skin ulcers , fever, low red blood cells, and enlarged spleen and liver after the bite of a Sand fly.Culture shows the following picture.Identify the infecting parasite. 

A.	Giardia.
B.	Leishmania.
C.	Trypanosoma.
D.	Plasmodium.

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Correct Answer � B Explanation

Ans:B.)Leishmania

The parasite shown in the image is Promastigote phase of Leishmania in the culture.

The patient in question is suffering from Visceral Leishmaniasis.

Leishmaniasis

• It is a disease caused by protozoan parasites of the genus Leishmania and spread by the bite of certain types of sandflies.
• The disease can present in three main ways: cutaneous, mucocutaneous, or visceral leishmaniasis(Kala azar/Black fever).
• The cutaneous form presents with skin ulcers, while the mucocutaneous form presents with ulcers of the skin, mouth, and nose, and the visceral form starts with skin ulcers and then later presents with fever, low red blood cells, and enlarged spleen and liver.
• Microscopic examination:direct visualization of the intracellular Amastigotes (Leishman-Donovan bodies).Amastigotes( formed after the macrophage phagocytizes an infective promastigote) are seen within blood and spleen monocytes or, less commonly, in circulating neutrophils and in aspirated tissue macrophages. They are small, round bodies 2–4 μm in diameter with indistinct cytoplasm, a nucleus, and a small, rod-shaped kinetoplast.
• Culture:Growth of Promastigotes in days to weeks.Promastigotes are characterized by a flagellum and a kinetoplast anterior to the nucleus. They are the infective stage to humans.