Leishmaniasis: clinical syndromes and treatment

Abstract

Leishmaniasis is a global term for cutaneous and visceral anthroponotic and zoonotic diseases caused by the vector-borne parasites of the genus Leishmania. These diseases afflict at least 2 million people each year with more than 350 million at risk in 98 countries worldwide. These are diseases mostly of the impoverished making prevention, diagnosis and treatment difficult. Therapy of leishmaniasis ranges from local treatment of cutaneous lesions to systemic, often toxic, therapy for disseminated cutaneous, mucocutaneous and deadly visceral disease. This review is a summary of the clinical syndromes caused by Leishmania and treatment regimens currently used for various forms of leishmaniasis.

Figure 1.

Leishmania life cycle and clinical syndromes. (A) Diagrammatic depiction of life cycle of Leishmania. (B) Giemsa stained preparation of L. donovani promastigotes, (C) Giemsa staining of touch preparation of a cutaneous lesion showing presence of intracellular parasites inside macrophages, (D) CL lesion on the hand, (E) mucocutaneous lesion (MCL) of the mouth and nose, (F) facial lesions in a case of PKDL, (G) emerging lesions within the old CL scar in LR and (H) lesions throughout in DCL. Credit for pictures: Panels: A, obtained from NIAID; B, www.lookfordiagnosis.com; C, Centers for Disease Control, www.CDC.gov; D, www.Dermnet.com; E, www.Drugline.org; F, www.WHO.int, G, www.globalskinatlas.com and H, Medical Books Online, www.cixip.com.