VISCERAL LEISHMANIASIS (VL) or Kala-azar, a life-threatening parasitic infection, is often caused by various strains of Leishmania donovani, L. infantum, and L. chagasi and is endemic in Middle East and Mediterranean regions. Northwest and southern Iran are the primary foci for VL, which mainly affect children, therefore, L. infantum is expected to be dominant Leishmania strain in Iran (1-3)....

Treatment of leishmaniases remains difficult, due to the multiplicity of the existing Leishmania species, and their often variable susceptibility to available drugs, which are old, toxic and expensive products. Resistance to the existing products is developing in some foci, such as India.

Background: VISCERAL LEISHMANIASIS (VL) has strong links with poverty, substantial medical and veterinary impacts. This review aimed to focus in studies published during 1994-2016 on VL in southeastern Iran. Methods: The present review is based on expert knowledge and historical studies published during the past 23 yr (1994-2016) on VL in southeastern Iran. In addition, related literature found in PubMed by using the keywords such as VISCERAL LEISHMANIASIS, kala-azar, and Leishmania infantum are included. Results: Overall, 118 children aged 4. 2 yr were detected as infected with human VL (HVL). The majority of the cases were from Orzoieh district (37. 1%) in southwest of Kerman Province, followed by Sirjan (15. 7%), Jiroft (14. 8%), Kahnuj (9. 3%) and to lesser extent from other areas. The male to female ratio was 1. 7. The three most frequent clinical features were represented by fever (100. 0%), anemia (95. 0%) and splenomegaly (91. 5%). Altogether, 42. 0% of the VL cases developed secondary bacterial infections, the overall case-fatality rate was 3. 4%, and majorities (88. 0%) of the VL patients were undernourished. Overall, 733 dogs and wild canines were examined by different techniques with various seroprevalence ranges. Conclusion: In southeastern Iran, VL is endemic in Orzoieh district in Kerman Province. While the dogs are implicated as the main domestic reservoir of VL, wide range of wild canines can serve as a secondary potential reservoir host.

BACKGROUND: Kala-azar is a multisystem infection of the reticuloendothelial system. Various hematologic abnormalities have been described in kala-azar including hemophagocytic syndrome (HPS).METHODS: We reviewed bone marrow aspirate smears from 18 documented cases of kala-azar complicated by HPS.RESULTS: The bone marrow smears were hypercellular with erythroid hyperplasia. Megaloblastic changes, foamy macrophages, activated macrophages with cytoplasmic vacuoles and elongated cytoplasmic process, intra- and extracellular amastigotes, cytoplasmic fragments (blue bodies), plasma cells with inclusions and hemophagocytic cells were seen. Leishman bodies (amastigotes) were also found in some hemophagocytic cells.CONCLUSION: Kala-azar should be considered as an etiology of HPS, particularly in endemic areas.