Visceral Leishmaniasis is a predominantly rural zooantroponose which is transmitted to man by a cryptozoite dipterous insect bite (DIPTERA) belonging to the Psychodidae family (Phlebotomus or Lutzomya longipalpis).
The canids (for instance, dog, fox: Lycalopex vetulus) are the most frequent animal hosts in our environment. The diagnosis was made based on the direct search for the Leishmania donovani (amastigote forms) in marrow material and through myeloculture in NNN (Mc Neal, Novy e Nicole) culture mean. The samples were obtained through aspirative punctures from the sternum (second intercostal space) and iliac crests (anterosuperior spine). Medular smears were stained with leishman.
We report here cytological alterations that occur in the bone marrow parenchima regarding morphology and cellularity. We studied 100 patients with Visceral Leishmaniasis whose bone marrow "aspirate" analysis disclosed the protozoary Leishmania donovani. The main alterations observed were the following:
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The presence of the above alterations lead us to search for protozoary in the bone marrow smears, especially in those cases where there was the diagnostic possibility of Visceral Leishmaniasis. However, even if all these alterations are found in the same suspected case, a diagnosis of Visceral Leishmaniasis cannot be determined until after the Leishmania donovani are actually found. Most of the alterations cited above have been previously described, and can be found in the international medical literature.
Our sincerest thanks to the medical staff and patients of the Infectious and Parasitic Service of Clinical Hospital of the University of São Paulo School of Medicine where most of this data was gathered.
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About the author: Nivaldo Medeiros, MD Former Director of the Hematology and Cytology Service of the Central Laboratory of the University of São Paulo School of Medicine. Former Assistant Physician of the Department of Clinical Pathology (Hematology Service) at the Cancer Hospital of São Paulo.
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