An update on Leishmania martiniquensis infections: Transmission, clinical characteristics, and treatment

Abstract

Leishmaniasis, caused by intracellular protozoa of the Leishmania genus, continues to be a global health issue, with approximately 700,000 to 1 million new cases occur annually worldwide. The disease is transmitted via the bite of infected female sand flies of the genus Phlebotomus, resulting in a range of symptoms known as cutaneous, mucocutaneous, and visceral leishmaniasis. The species Leishmania (Mundinia) martiniquensis, discovered in 1995, has been linked to cases in individuals with HIV, presenting with diverse clinical pictures. Interestingly, biting midges, not sandflies, has proved to serve as its potentially biological vector. This study focuses on understanding the transmission, clinical aspects, and effective treatment of L. martiniquensis infections. A comprehensive search strategy was employed to identify relevant published papers on the epidemiology, transmission, clinical characteristics, and treatment of L. martiniquensis up to August 2024. The clinical manifestations encompass localized cutaneous leishmaniasis, disseminated cutaneous leishmaniasis, mucocutaneous leishmaniasis, and visceral leishmaniasis. Leishmaniasis is associated with comorbidities such as inadequate nutrition, population displacement, and reduced immunity. Risk factors for Leishmania infection include the presence of domestic animals, age, gender, and environmental factors. Amphotericin B deoxycholate (AmB) is the main treatment. Combination therapy with allicin and andrographolide may reduce AmB side effects. Recent research investigates other treatments including 8-hydroxyquinoline, which works synergistically with AmB against L. martiniquensis.

Keywords: Amphotericin B; Clinical features; Leishmania martiniquensis; Leishmaniasis; Midges.

Fig. 1

Maximum likelihood phylogenetic tree of the Leishmania based on internal transcribed spacer 1 sequences. The evolutionary relationships among diverse species are illustrated by the tree, which includes representatives from different Leishmania subgenera (Mundinia, Viannia, Leishmania, and Sauroleishmania). The nodes are provided with bootstrap values from 1000 replicates. Trypanosoma cruzi is classified as an outgroup.

Fig. 2

Global distribution of proven leishmaniasis caused by Leishmania martiniquensis.