Leishmaniasis.

Abstract

Leishmaniases comprise clinically distinct diseases caused by the protozoan parasite leishmania, which is transmitted through the bite of infected sand flies. Cutaneous leishmaniasis is the most common form and manifests as a localized skin lesion. Mucosal leishmaniasis causes destructive nose, mouth, and throat lesions. Visceral leishmaniasis is a potentially life-threatening form that results from bloodborne dissemination of the parasites. The number of cases of cutaneous leishmaniasis is increasing, particularly in the Eastern Mediterranean region, and the prevalence of visceral leishmaniasis is decreasing globally. Laboratory diagnosis of the leishmaniases has shifted to the use of molecular methods to test tissue samples (e.g., skin or bone marrow), which can be used to identify infecting species. Treatment is challenged by limited drug choices. A recent advance is the use of combination therapies for visceral leishmaniasis. Two human leishmaniasis vaccines are undergoing preclinical testing or are ready for human testing.