An obligate intracellular protozoan parasitic disease transmitted by the bite of some species of sandflies.
Most commonly manifests either in a cutaneous or in a visceral form.
Transmitted mostly by infected sandflies which are noiseless fliers that prefer dark places and are active in the evening, but can be transmitted congenitally and parenterally.
Leishmania Is endemic in 98 countries or t2242itories worldwide.
More than 90% of the world’s cases of cutaneous leishmaniasis occur in Afghanistan, Algeria, Brazil, Peru, and the middle east.
More than 90% of the world’s cases of visceral leishmaniasis occur in Bangladesh, India, Brazil, Nepal, and the Sudan.
Estimated yearly incidence of Leishmania infection is 1.5 million cases of cutaneous form and 500,000 cases of visceral Leishmaniasis.
75% of cases in the U.S. originate in Latin America.
Travelers who are active in the evenings are at risk.
Cutaneous form is characterized by one or more skin lesions that develop weeks to months after a person is bitten by infected sandflies.
Skin lesions may be single or multiple and can be small dry lesions to large ulcerating ones and usually occur on exposed areas of the body.
Cutaneous form results from the paratization of skin macrophage and manifest as a papule that enlarges to a nodule that often ulcerates within 1 to 3 months.
The skin lesions can last from weeks to years and may develop raised edges and a central ulcerations.
Cutaneous leishmaniasis resolves without treatment in a few months to several years, depending on the infecting species.
Cutaneous form leads to morbidity due to presence of skin ulcer and presence of disfigurement.
Visceral form can cause fever, weight loss, hepatosplenomegaly and anemia.
Visceral form, if left untreated, is fatal.
Diagnosis based on history and skin lesions and demonstration of parasite on Geimsa stained slides of the lesions.
Most cases of cutaneous disease are self-limited and heal within weeks to 3 years without being treated.
Multiple species because cutaneous Leishmaniasis.
May be transmitted via transfusion and can cause severe clinical illness and immunosuppressed and newborns.
Treatment with pentavalent antimony agents are the main treatments, but amphotericin B and pentamidine are alternative drugs.