Indian visceral leishmaniasis (kala-azar, Hindi for "black fever", originally applied to patients who develop a diffuse skin hyperpigmentation) is a systemic disease that involves the liver, spleen, bone marrow and reticuloendothelial system. Jha et al listed criteria for identifying a patient with severe disease.
Findings indicating severe kala-azar are:
(1) massive splenomegaly (spleen > 12 cm below the left costal margin)
(2) severe anemia (hemoglobin < 6.5 g/dL)
(3) severe leukopenia (white blood cell count < 2,000 per µL)
(4) moderate to severe thrombocytopenia (platelet count < 75,000 per µL)
where:
• The pancytopenia is due to marrow involvement and hypersplenism, and not due to other causes.
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