What Is It?

Risk Factors -Geography (95% of cutaneous cases occur

in Middle East and 90% of visceral cases occur in India).

-Socioeconomic Conditions (e.x poverty, malnutrition, famine and illiteracy).

-Being immunnocompromised (e.x HIV patients and pregnant women) .

Pathophysiology

After infection, promastigotes from the vector are phagocyted by host macrophages; inside these cells, they transform into amastigotes. The parasites may remain localized in the skin or spread to internal organs or the mucosal of the mucosa of the nasopharynx, resulting in 3 major clinical forms of leshmaniasis: cutaneous, visceral and mucosal.

Types

- Cutaneous leishmaniasis: the causative agents are L.major and L.tropica in southern Europe, Asia and Africa; L.mexicana in Mexico and South America; and L.braziliensis in South America.

- Visceral leishmaniasis: is caused by L.donovani and L.infantum/chagai and occur in India, Sudan, Central Asia, South and Central America.

- Mucosal leishmaniasis: is caused mainly by L.braziliensis.

Treatment & Prevention

Treatment: is with liposomal amphotericin B, amphotericin B deoxycholate, pentavalent antimony compounds (sodium stibogluconate, meglumine antimonite), or miltefosine, depending on causative agents.Prevention: used insect repellents with DEET, insect screens, bed nets, reduction of vector population by spraying residual insecticide. Vaccines are not available yet.

Complications

- Secondary bacterial infection, including pneumonia and tuberculosis.

- Bleeding (hemorrhage) VL.- Facial disfigurement ML.- Rupture spleen VL.

Diagnosis- Light microscopy of tissue samples, touch preparation, or aspirates.- For Visceral leishmaniasis, antibody titers.- For Cutaneous leishmaniasis, skin testing.- Culture (special media required).

Leishmaniasis

It is a disease caused by an intracellular protozoan parasite (genus Leishmania)

transmitted by the bite of a female phlebotomine sandfly .

Signs & SymptomsCutaneous Visceral Mucosal

Painless chronic lesions rang from nodules to large ulcer.

Irregular fever, hepatosple-nomegaly, pancytopenia.

Ulcers in the mouth, nose or lip,

bleeding and runny nose.