Leishmania — Kala-azar

A 35-year-old male from Bihar presents with a 6-month history of fever, hepatosplenomegaly, and pancytopenia. Bone marrow examination reveals Leishman–Donovan bodies. What is the drug of choice for treatment of this kala-azar?

A 28-year-old male from Bihar presents with a 3-month history of fever, progressive abdominal distension, and weight loss of 8 kg. On examination, he is cachectic with hepatomegaly (liver edge 5 cm below costal margin) and splenomegaly (spleen palpable 4 cm below costal margin). His hemoglobin is 8.2 g/dL, WBC 2,100/μL, and platelets 95,000/μL. Bone marrow aspiration shows numerous intracellular amastigotes within macrophages. What is the most likely diagnosis?

A 35-year-old woman from Assam presents with a 4-month history of fever, weight loss, and abdominal swelling. She received 28 days of sodium stibogluconate 3 months ago for kala-azar, with initial clinical improvement. Now she has relapsed with fever, hepatosplenomegaly, and a hemoglobin of 7.8 g/dL. Bone marrow smear again shows amastigotes. Which of the following is the most appropriate management?

A 28-year-old woman from an endemic area (Jharkhand) presents with fever, splenomegaly, and anemia (Hb 7.5 g/dL). Bone marrow aspiration shows amastigotes confirming kala-azar. Which investigation is most appropriate to assess disease severity and monitor treatment response?

Regarding the clinical features and laboratory findings in visceral leishmaniasis (kala-azar), all of the following statements are correct EXCEPT: