Splenic aspiration in the diagnosis and follow up of Kala-azar

Abstract

15 cases of visceral leishmaniasis (5 untreated and 10 relapse cases) were studied to find the relative sensitivity and safety of splenic and bone-marrow aspiration procedures in the diagnosis and follow up of Kala-azar. A total of 90 splenic and 41 bone-marrow aspirations were done is them. These included one splenic and one bone-marrow aspiration prior to therapy in each of these 15 patients while the remaining aspirations were carried out at serial intervals following the start of therapy. Diagnosis of visceral leishmaniasis was established in 9 cases by both splenic as well as bone-marrow aspiration but the remaining 6 patients were positive only by splenic aspirations. When positive, splenic aspirate smear on the slide revealed greater number of parasites. Further, out of the 10 cases of stibogluconate relapse, 83 percent (5 out of 6) were those which could be diagnosed by splenic aspiration only. It was also observed that when compared to bone marrow aspiration, splenic aspirates continued to show LD bodies for a longer time during the treatment follow up especially in the antimony unresponsive group but once negative, no relapses occurred during a 6 month observation period. Aspiration from spleen was found to be less painful, a short procedure and without serious complications.