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File: 123096_sep96_decls23_0021.txt
Subject: DIAGNOSIS AND TREATMENT OF DISEASES OF IMPORTANCE
Unit: OTSG
Parent Organization: HSC
Box ID: BX003203
Folder Title: DIAGNOSIS AND TREATMENT OF DISEASES 1991PORTABLE FIELD PERSONNEL SHOWER SYSTEMS
Document Number: 1
Folder Seq #: 88
6 Skin:
a trophic changes (due to malnutrition): D. X-ray:
thinning, dryness, hair loss, hypopigmenta- 1. Standard examinations are nonspecific.
tion. 2. Hepatomegaly and splenomegaly can be detected by
b. polymorphic lesions: papules, wart-like appropriate imaging modalities (sonogram, CT,
nodules, ulcers (rare). etc.).
C. petechiae, purpura, bruises.
7. Eye: retinal hemorrhage, papilledema, yelid E. Invasive procedures:
nodules, anterior uveitis. 1. Bone marrow aspiration with Wright or Giemsa
B. Jaundice (in advanced disease). stains of smear (54-86% sensitive).
9. Nodules or ulcers of oral and/or nasopharyngeal 2. splenic aspiration with Wright, Giemsa, or Leish-
mucosa (rare). man's stain of smear (98% sensitive).
10. Edema (typically late). a. contraindications include: physician inex-
11. Bleeding: epistaxis, gingival, vaginal, other perience; soft spleen in acute disease; PT
prolonged 5 seconds or more ab3ve normal,
low 50,000/mm.
12. Ascites (advanced disease). 3. Liver biopsy/aspiration: sensitivity similar to
Laboratory: splenic aspiration, but higher risk of hemorrhage.
1. Hematologic! 4. Lymph node aspiration/biopsy: less sensitive than
a. anemia (normochromic, normocytic). above tests. Avoid femoral or inguinal nodes
b. marked leukopenia (95% with WBC < 3000/MM@ because they are less likely to be diagnostic.
C. thrombocytopenia.
d. Coombs test, usually positive. F. Skin testing: Ieishmanin skin test will be negative in
a. marked decrease or absence of eosinophils. active disease and is not useful for diagnosis.
f. parasitemia may be occasionally detected on G. Diagnostic confirmation:
peripheral blood smear.
9. buffy coat smears may be diagnostic. 1. The diagnosis must be confirmed by the demonstra-
2. Chemistries: tion of parasites in a bone marrow aspirate or
a. Polyclonal hypergammaglobulinemia. biopsy.
b. positive rheumatoid factor. 2. Culture of organism from tissue aspirate/specimens
C. hypoalbuminemia. is possible with specialized technique (NNN or
elevated transaminases. Schneider's media), but this should only be
a. hyperbilirubinemia (advanced disease). attempted a facilities with experience in cul-
3. Urinalysis: turing leishmania.
a. proteinuria (occasional).
b. hematuria (occasional). IV. Duration:
4. Microbiologic: standard microbiologic techniques A. Treated: varies with therapeutic regimen; generally
are not applicable.
5 . Serologic: about 1 month with sodium stibogluconate (Pentostam)
a. ELISA is most sensitive (98%) but is non- therapy; however, fever will respond within 48 to 72
specific. hours of starting therapy, and the patient will feel
b. indirect immunofluorescent antibody tests may improved within the first week.
be more readily available (95% sensitive) B. Untreated: indefinite,, usually fatal in months.
C. complement fixation, counter-im-
munoelectrophoresis, hemagglutination, and V. Complications:
agglutination tests are less specific.
6. Coagulation:
a. bleeding and clotting times are generally A. Renal:
normal. 1. Renal amyloidosis with nephrotic syndrome.
ged 2. Immune-complex mediated glomerulonephritis.
(2 to 4 seconds more than control).
3 2
3 3
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Document 52 f:/Week-36/BX003203/DIAGNOSIS AND TREATMENT OF DISEASES 1991PORTABLE FIELD PERSONNEL SHOWER SYSTEMS/diagnosis and treatment of diseases of importanc:12179609281524
Control Fields 17
File Room = sep96_declassified
File Cabinet = Week-36
Box ID = BX003203
Unit = OTSG
Parent Organization = HSC
Folder Title = DIAGNOSIS AND TREATMENT OF DISEASES 1991PORTABLE FIELD PERSONNEL SHOWER SYSTEMS
Folder Seq # = 88
Subject = DIAGNOSIS AND TREATMENT OF DISEASES OF IMPORTANC
Document Seq # = 1
Document Date =
Scan Date =
Queued for Declassification = 01-JAN-1980
Short Term Referral = 01-JAN-1980
Long Term Referral = 01-JAN-1980
Permanent Referral = 01-JAN-1980
Non-Health Related Document = 01-JAN-1980
Declassified = 17-DEC-1996