Post kala-azar ocular leishmaniasis

Abstract

The clinical features, diagnosis and treatment of 6 patients with post kala-azar ocular leishmaniasis are described. The eye lesions were associated with past or concomitant post kala-azar dermal leishmaniasis (PKDL). Four patients had post kala-azar leishmanial conjunctivitis and blepharitis. Using the polymerase chain reaction, the causative parasite was characterized as Leishmania donovani in 2 of these 4 patients. Two patients had post kala-azar anterior uveitis. The diagnosis of uveitis was based on the clinical manifestations, temporal relation to treated visceral leishmaniasis, the association with PKDL and positive anti-Leishmania serology. All patients were treated with systemic sodium stibogluconate. Patients with anterior uveitis were also treated with steroid and atropine eyedrops. The response to treatment was good. The importance of early diagnosis and treatment of ocular leishmaniasis is stressed.