Classification: ICD-9 085.0; IDC-10 B55.0
Syndromes and synonyms: Kala-azar (Hindi for black sickness), black disease, dum-dum fever.
Agent: Parasite, kinetoplastida. Leishmania donovani and its subspecies donovani and infantum. L. chagasi is considered to be the same species as L. infantum, and are referred to as L. infantum/chagasi. Occasionally, other Leishmania spp. can cause visceral disease, usually in immunocompromised individuals.
Reservoir: Humans (mainly L. donovani), wild Canidae (foxes, raccoon dogs, jackals, wolves), domestic dogs (mainly L. infantum/chagasi), and rodents.
Vector: Phlebotomine sandfly: Lutzomyia spp. (New World) and Phlebotomus spp. (Old World).
Transmission: Bite of infective female sandfly. Rare reports exist of non-vector transmission, including transmission by blood transfusion, sharing of syringes, venereal contact, and possibly transplacentally; potential transmission via organ transplantation.
Cycle: During blood meal, the sandfly ingests infected blood with amastigotes. The amastigotes develop to motile promastigotes that multiply in the sandfly gut, and finally motile promastigotes travel to the mouth parts and are injected into another host during feeding. In the host cell the promastigotes develop into amastigotes.
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