Leishmaniasis

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Medical Author:

Mary D. Nettleman, MD, MS, MACP

Mary D. Nettleman, MD, MS, MACP

Mary D. Nettleman, MD, MS, MACP is the Chair of the Department of Medicine at Michigan State University. She is a graduate of Vanderbilt Medical School, and completed her residency in Internal Medicine and a fellowship in Infectious Diseases at Indiana University.

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Medical Editor:

Charles Patrick Davis, MD, PhD

Charles Patrick Davis, MD, PhD

Dr. Charles "Pat" Davis, MD, PhD, is a board certified Emergency Medicine doctor who currently practices as a consultant and staff member for hospitals. He has a PhD in Microbiology (UT at Austin), and the MD (Univ. Texas Medical Branch, Galveston). He is a Clinical Professor (retired) in the Division of Emergency Medicine, UT Health Science Center at San Antonio, and has been the Chief of Emergency Medicine at UT Medical Branch and at UTHSCSA with over 250 publications.

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• Leishmaniasis is caused by a parasite that is spread to humans through the bite of infected sand flies.
• Leishmaniasis exists in many temperate and tropical countries of the world. The disease is most common in India, Bangladesh, Nepal, Sudan, Ethiopia, Afghanistan, Algeria, Iran, Saudi Arabia, Syria, Brazil, Colombia, Peru, and Bolivia.
• The most common type of leishmaniasis is cutaneous leishmaniasis. This causes nodules or sores to form on the skin, including the skin of the face. Affected people may have a single lesion or many lesions. Sores heal slowly over months to years and leave scars.
• Another type is called visceral leishmaniasis. Parasites infect the tissues of key organs, especially the liver, spleen, and bone marrow. Serious cases are usually fatal if not treated.
• Uncommonly, people who have had cutaneous leishmaniasis may get new sores in the mucous membranes of the mouth, nose, and larynx even years after the cutaneous leishmaniasis has resolved. This is called mucocutaneous leishmaniasis and only occurs in limited areas of the New World.
• Treatment consists of medications that are specific to the type of leishmaniasis, the species of the parasite, and to the country in which the disease was acquired.
• Consultation with the CDC and an infectious-disease consultant is strongly recommended for assistance with diagnosis and treatment of cases imported into the United States.
• Those who work in or travel to affected areas can reduce their risk by using insect repellents, protective clothing, and bed nets. These precautions are especially important after dusk, because that is when the sand fly is most active.

Leishmaniasis is an infection caused by a parasite that is spread to people through the bite of the female phlebotomine sand fly. The parasite exists in many tropical and temperate countries. Cases in the United States are almost always imported from other countries by travelers or immigrants. It has been estimated that there are 2 million new cases of leishmaniasis every year in the world, of which 1.5 million are categorized as cutaneous leishmaniasis and 0.5 million are visceral leishmaniasis. Epidemics occur when people are displaced into affected regions through war or migration or when people in affected regions experience high rates of disease or malnutrition.

Figure 1: Picture of a sand fly biting a human arm. SOURCE: CDC/Frank Collins