Diagnosis of symptomatic visceral leishmaniasis by use of the polymerase chain reaction on patient blood

J Infect Dis. 1995 Mar;171(3):751-4. doi: 10.1093/infdis/171.3.751.

Abstract

To diagnose symptomatic visceral leishmaniasis (kala-azar) using peripheral blood rather than tissue aspirates, a polymerase chain reaction (PCR) technique was developed for which the detection limit is 1 Leishmania-infected macrophage in 8 mL of blood. For Indian, Kenyan, or Brazilian patients with parasitologically confirmed kala-azar, 57 of 63 cases before treatment had blood that was PCR-positive (90% sensitivity). None of 40 clinically healthy persons had PCR-positive blood (100% specificity). Twelve (92%) of 13 clinically cured Indian patients had negative PCR reactions 1-6 months after treatment. This PCR procedure can provide a parasitologic diagnosis for the vast majority of kala-azar cases before therapy, may identify patients who have been successfully treated by chemotherapy, and should substantially reduce the need for invasive tests.

MeSH terms

  • Base Sequence
  • Humans
  • Leishmaniasis, Visceral / diagnosis*
  • Molecular Sequence Data
  • Parasitemia / diagnosis*
  • Polymerase Chain Reaction*
  • Sensitivity and Specificity