Diagnosis and treatment of Indian visceral leishmaniasis.

LD bodies are identified by light microscopy of the specimen obtained after staining with Giemsa or Leishman stain. The sensitivity of splenic aspirate smear is more than 95% and is regarded as the gold standard for the diagnosis of Kala-azar. But the sensitivity of bone marrow smear is only about 60-85% and the procedure is painful whereas splenic aspiration carries the risk of severe hemorrhage. Eventhough this fatal complication is rare in experienced hands, splenic puncture should be avoided in patients with a platelet count of less than 40,000/μL and a prothrombin time of more than five seconds over the control.