A 25-year-old from Bihar develops prolonged fever, hepatosplenomegaly, and weight loss. Bone marrow aspirate shows macrophages filled with small intracellular organisms. The vector responsible for transmission is:
- A Phlebotomus sandfly ✓
- B Anopheles mosquito
- C Triatoma bug (Reduviid bug)
- D Tsetse fly
Correct answer: A. Phlebotomus sandfly
Explanation
Visceral leishmaniasis (kala-azar) caused by Leishmania donovani is transmitted by the female Phlebotomus argentipes sandfly in the Indian subcontinent. Amastigotes (LD bodies) are found intracellularly within macrophages in the reticuloendothelial system, seen in bone marrow, splenic, and lymph node aspirates. The clinical triad of prolonged fever, progressive massive splenomegaly, and cachexia with darkening of skin is characteristic. Miltefosine (oral) is the treatment of choice in India.
Reference: Ananthanarayan & Paniker's Textbook of Microbiology, 11th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
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