Visceral leishmaniasis

This item appears on page 14 of the October 2011 issue.
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My husband, Ed, and I traveled to Vietnam, Laos and Cambodia for a month in the fall of 2009. We had a wonderful trip and enjoyed every moment of our travels.

In the summer of 2010, however, my husband found he didn’t have much energy — he didn’t feel good, but he didn’t feel bad either. He complained to the doctors, but when you are going to be 70 on your next birthday, no matter how young and active you have kept yourself you are still going to be 70.

In January 2011 his condition became much worse. To make a very long saga short, he saw many doctors, had blood drawn over and over and had CAT scans, PET scans, x-rays and various other tests.

At one point, the doctors thought he had a terrible type of cancer. The oncologist finally said his spleen was too diseased to ever heal, so they would have to remove it. By the time he went in for the surgery on March 17, he had lost 30 pounds; the doctor said he was about a day from death.

This was major surgery because the spleen needed to be taken out whole so testing could be done. He was in the hospital for five days. Some of the spleen was tested at our hospital in Texas and some of it by a pathologist in California, who couldn’t figure out the problem. It was then sent to a tropical infectious diseases pathologist, who immediately identified visceral leishmaniasis.

After that, my husband was put in the hospital for five days of chemotherapy. The infusion made him sick but was necessary. He went home for eight days, had an outpatient day of infusion and then went back for seven more days of another infusion. He finished his treatment at the end of April 2011.

He has lost much muscle mass because he didn’t have the energy to do anything but rest and sleep, but now he is back walking again daily and building himself up.

As I understand it, leishmaniasis is a parasite found in the saliva of a sand fly and is transferred from an infected dog or fox. Among parasitic killers, it is second only behind malaria in the number of people in the world it kills.

He could have contracted the disease from other places we had visited, but Southeast Asia has a lot of cases and the time frame seems to correspond with his having contracted it on that trip.

Living without a spleen is something one can do. However, the other place the parasite can go is the heart. If that happens, there is nothing that can be done for it unless it’s caught quickly. We are thankful the spleen took care of his.

He’ll have to be more careful when we travel in the future, as his immune system is diminished, and he’ll have to take malaria pills wherever there is a possibility of malaria.

I thought sharing this information might help someone else get a quicker diagnosis and not have to go through what our family did. Leishmaniasis is not common in East Texas, so it took a long time to figure it out.

KATHY HOFFMAN
Marshall, TX

Please login or subscribe to ITN to read the entire post.

My husband, Ed, and I traveled to Vietnam, Laos and Cambodia for a month in the fall of 2009. We had a wonderful trip and enjoyed every moment of our travels.

In the summer of 2010, however, my husband found he didn’t have much energy — he didn’t feel good, but he didn’t feel bad either. He complained to the doctors, but when you are going to be 70 on your next birthday, no matter how young and active you have kept yourself you are still going to be 70.

In January 2011 his condition became much worse. To make a very long saga short, he saw many doctors, had blood drawn over and over and had CAT scans, PET scans, x-rays and various other tests.

At one point, the doctors thought he had a terrible type of cancer. The oncologist finally said his spleen was too diseased to ever heal, so they would have to remove it. By the time he went in for the surgery on March 17, he had lost 30 pounds; the doctor said he was about a day from death.

This was major surgery because the spleen needed to be taken out whole so testing could be done. He was in the hospital for five days. Some of the spleen was tested at our hospital in Texas and some of it by a pathologist in California, who couldn’t figure out the problem. It was then sent to a tropical infectious diseases pathologist, who immediately identified visceral leishmaniasis.

After that, my husband was put in the hospital for five days of chemotherapy. The infusion made him sick but was necessary. He went home for eight days, had an outpatient day of infusion and then went back for seven more days of another infusion. He finished his treatment at the end of April 2011.

He has lost much muscle mass because he didn’t have the energy to do anything but rest and sleep, but now he is back walking again daily and building himself up.

As I understand it, leishmaniasis is a parasite found in the saliva of a sand fly and is transferred from an infected dog or fox. Among parasitic killers, it is second only behind malaria in the number of people in the world it kills.

He could have contracted the disease from other places we had visited, but Southeast Asia has a lot of cases and the time frame seems to correspond with his having contracted it on that trip.

Living without a spleen is something one can do. However, the other place the parasite can go is the heart. If that happens, there is nothing that can be done for it unless it’s caught quickly. We are thankful the spleen took care of his.

He’ll have to be more careful when we travel in the future, as his immune system is diminished, and he’ll have to take malaria pills wherever there is a possibility of malaria.

I thought sharing this information might help someone else get a quicker diagnosis and not have to go through what our family did. Leishmaniasis is not common in East Texas, so it took a long time to figure it out.

KATHY HOFFMAN
Marshall, TX