Abstract:
Background: Visceral leishmaniasis or Kalazar has been a major health burden on the Sudanese patients and to the health authority in Sudan. Delay in diagnosis of VL lead to serious complications and eventually death. By use of ultrasound these complication can be diagnosed early and treating them before damaging the spleen, liver, lymph nodes and bone marrow and death to occur.
Objectives: to study ultrasound findings (signs and complications) of VL in Sudanese patients in Omdurman Tropical Diseases Teaching Hospital in the period from March to August 2011.
Methodology: This is descriptive prospective cross-sectional hospital-based study of 50 Sudanese patients with VL, attended Ultrasound Department. The data collected by using data collection sheet, which included personal data, duration of the disease and ultrasound findings of abdominal examination. The data arranged in the master sheet, entered computer and analyzed by Excel Program.
Results: Ultrasound findings were most common in the age group 15 – 30 years in 20 patients (40%) and age group 31 – 45 years 18 (36.0%), less common in age group >45 (14%) and <15 years (10%). Ultrasound findings were most common in males (76%) than females (24%) (with ratio 3.6 : 1). Distribution of patients according to the regions as follow: eastern states were 27 (54.0%), central states were 13 (26.0%), southern states were 5 (10%), northern states were 2 (4%), western states were 2 (4%), and from Khartoum State 1 patient (2%). Ultrasound findings according to the duration of illness, < 4 weeks 5 patients (10%), 4-8 weeks 20 patients (40%) and >8 weeks 25 patients (50%). Ultrasound findings among the study patients with VL include splenomegally 47 (94%), hepatomegally 43 patients (86%), lymph adenopathy 45 patients (90%), ascites 12 patients (24%), pleural effusion 8 patients (16%), portal vein dilatation 5 patients (10%), inferior vena cava dilatation 4 patients (8%), increased echogenicity of the kidneys 2 patients (4%) and decreased echogenicity of pancreas 1 patients (2%). The spleen size by ultrasound, normal size 3 (6%), mild splenomegally 5 (10%), moderate 10 patients (20%), marked splenomegally 32 patients (64%). The size of the liver by ultrasound, normal size 7 patients (14%), mild hepatomegaly 8 (16%), moderate hepatomegaly 10 (20%) and marked hepatomegally 25 (50%). The lymph node size by ultrasound, normal size 5 (10%), mild lymph adenopathy 5 (10%), moderate 10 (20%) and marked lymph adenopathy 30 (60%).
Conclusion: Ultrasound findings were most common in young males from east and central states with prolong disease duration. Splenomegally, hepatomegally, lymph adnopathy were the most common ultrasound findings. Ascites and plural effusion, dilatation of the portal vein and inferior vena cava were less common, while the increased echogenicity of the kidneys and decreased echogenicity pancreas were very rare ultrasound findings. Thus ultrasound has capability of diagnosis of VL and differentiated it from mimicking conditions in combination with other laboratory tests.
