Werneck et al identified risk factors for death in a patient with visceral leishmaniasis (kala-azar). These can help to identify a patient who may benefit from more aggressive management. The authors are from Universidade do Estado do Rio de Janeiro and Universidade Federal do Piaui in Brazil.
Risk factors for death identified on multivariate analysis::
(1) severe anemia, with hematocrit < 20 percent
(2) chronic fever lasting > 60 days (2 months)
(3) diarrhea
(4) jaundice (presumably indicative of liver disease)
Additional findings associated with mortality:
(1) malnutrition
(2) serious or recurrent infection, especially pneumonia (major cause of death)
(3) hemorrhage (major cause of death, possibly related to liver disease)
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