Leishmaniasis: Introduction, Epidemiology, and More (PDF)

Introduction The most common form is cutaneous leishmaniasis, which causes skin sores. The sores typically develop within a few weeks or months of the sand fly bite. The sores can change in size and appearance over time. The sores may start out as papules (bumps) or nodules (...

Introduction The most common form is cutaneous leishmaniasis, which causes skin sores. The sores typically develop within a few weeks or months of the sand fly bite. The sores can change in size and appearance over time. The sores may start out as papules (bumps) or nodules (lumps) and may end up as ulcers (like a volcano, with a raised edge and central crater); skin ulcers might be covered by scab or crust. The sores usually are painless but can be painful. Some people have swollen glands near the sores (for example, under the arm, if the sores are on the arm or hand). 2024-7-8 71  Epidemiology and Geographic Distribution Leishmaniasis is found in people in focal areas of approximately 90 countries in the tropics, subtropics, and southern Europe. In the Old World (the Eastern Hemisphere), leishmaniasis is found in some parts of Asia, the Middle East, Africa and southern Europe In the New World (the Western Hemisphere), it is found in some parts of Mexico, Central America, and South America. 2024-7-8 72  The first sign, a red papule, appears at the site of the fly’s bite. This lesion becomes irritated, with intense itching, and begins to enlarge & ulcerate. Gradually the ulcer becomes hard and crusted and exudes a thin, serous material. At this stage, secondary bacterial infection may complicate the disease. 2024-7-8 73 2024-7-8 74 Laboratory Diagnosis Demonstration of the amastigotes in prope rl y sta in ed sme ars from touc h preparations of ulcer biopsy specimen. Serological tests based on fluorescent antibody tests. Leishman skin test in some species. Molecular Diagnosis PCR detection, more sensitive and rapid. 2024-7-8 75  Treatment and prevention Treatment The drug of choice is sodium stibogluconate. Prevention Avoiding endemic areas especially during times when local vectors are most active. Prompt treatment of infected individuals 2024-7-8 76  Mucosal leishmaniasis 2024-7-8 77 Introduction Another potential concern applies to some (not all) types of the parasite found in parts of Latin America These types might spread from the skin and cause sores in the mucous membranes of the nose, mouth, or throat (mucosal leishmaniasis). Parasites disseminate from the skin to the naso-oropharyngeal mucosa. Adequate systemic treatment of cutaneous leishmaniasis reduces the risk for mucosal disease. 2024-7-8 78  Nasal stuffiness or bleeding Ulcerative destruction of the naso- oropharyngeal mucosa if untreated 2024-7-8 79 African Trypanosomiasis (Sleeping sickness) 2024-7-8 80