Kala-azar is the visceral form of leishmaniasis which is fatal without treatment. There is widespread infection of reticuloendothelial cells with Leishmaniasis donovani.
The name is from the Hindu meaning black fever, after the black colouration of the hands, feet, face and abdomen seen in Indian patients.
The protozoan is acquired by inoculation by the bite of a contaminated blood sucking, phlebotomine sand-fly. There is a reservoir of infection amongst small rodents. In India humans are the only reservoir.
Diagnosis is by histological demonstration of the parasite - Leishman-Donovan bodies - in splenic aspirate, bone marrow or lymph nodes, or by culture of these. Serologic tests are also available.
Treatment is with leishmanicides, e.g. sodium stibogluconate.
Last reviewed 07/2021