leishmaniasis

Leishmaniasis: A Parasitic Disease

Leishmaniasis is a group of diseases caused by protozoan parasites from more than 20 Leishmania species [4]. It is characterized by irregular bouts of fever, weight loss, enlargement of the spleen and liver, and anemia [1]. The disease can cause skin lesions, mucosal ulcers, and systemic infections, which can be fatal if left untreated [5].

Forms of Leishmaniasis

There are three main forms of leishmaniasis: cutaneous, mucosal, and visceral. Cutaneous leishmaniasis affects the skin, causing sores or lesions that can take months to heal [10]. Mucosal leishmaniasis affects the mucous membranes, causing ulcers in the mouth, nose, and throat [3]. Visceral leishmaniasis is the most severe form, affecting the internal organs and causing symptoms such as fever, weight loss, and anemia [5].

Transmission

Leishmaniasis is spread by the bite of a sandfly infected with the protozoa Leishmania [7][9]. The disease is endemic in more than 70 countries, particularly in tropical and subtropical regions of Asia, Africa, and Latin America [8].

Symptoms

The symptoms of leishmaniasis can vary depending on the form of the disease. Common symptoms include:

• Irregular bouts of fever
• Weight loss
• Enlargement of the spleen and liver
• Anemia
• Skin lesions or sores (cutaneous leishmaniasis)
• Mucosal ulcers (mucosal leishmaniasis)

References

[1] Jan 12, 2023 — It is characterized by irregular bouts of fever, weight loss, enlargement of the spleen and liver, and anaemia. Most cases occur in Brazil, east ...

[3] Mar 13, 2024 — The term leishmaniasis encompasses multiple clinical syndromes, including the cutaneous, mucosal, and visceral forms, which result from ...

[4] The leishmaniases are a group of diseases caused by protozoan parasites from more than 20 Leishmania species. · There are three main forms of the disease: ...

[5] Visceral leishmaniasis is characterized by irregular episodes of fever, weight loss, hepatosplenomegaly, and anemia and, if left untreated, causes death in more ...

[7] Leishmaniasis is a parasitic disease spread by the bite of the sandfly and can cause skin disease and systemic disease. The systemic form can be fatal, ...

[8] by E Torres-Guerrero · 2017 · Cited by 1230 — Leishmaniasis is caused by an intracellular parasite transmitted to humans by the bite of a sand fly. It is endemic in Asia, Africa, the ...

[9] Leishmaniasis is a parasitic disease transmitted by sandflies infected with the protozoa Leishmania. Leishmaniasis is endemic in more than 70 countries ...

[10] Result: noun | sores resulting from a tropical infection by protozoa of the genus Leishmania which are spread by sandflies

Leishmaniasis Signs and Symptoms

Leishmaniasis, a disease caused by the Leishmania parasite, can manifest in different forms, including visceral, cutaneous, and mucocutaneous. The signs and symptoms of leishmaniasis vary depending on the form of the disease.

Common Symptoms:

• Fever [1]
• Weight loss [1][6][9]
• Enlargement (swelling) of the spleen and liver [1][5][7][9]

Cutaneous Leishmaniasis Symptoms:

• One or more skin sores, which can change in size and appearance over time [3]
• Skin ulcers that heal very slowly [4]

Visceral Leishmaniasis Symptoms:

• General symptoms such as fever, weight loss, and abdominal swelling [2][6][9]
• Breathing difficulty [4]
• Stuffy nose, runny nose, and nosebleeds [4]

Other Possible Symptoms:

• Weakness [9]
• Decreased production of blood cells [9]

It's worth noting that some people may not show any symptoms at all (asymptomatic infection) while others can experience severe complications. The severity and duration of the symptoms can vary depending on individual factors.

References: [1] - Context result 1 [2] - Context result 2 [3] - Context result 3 [4] - Context result 4 [5] - Context result 5 [6] - Context result 6 [7] - Context result 7 [8] - Context result 8 [9] - Context result 9

Diagnosing Leishmaniasis: A Comprehensive Overview

Leishmaniasis, a disease caused by the Leishmania parasite, can be diagnosed through various methods. Here are some of the key diagnostic tests used to detect this condition:

• Tissue Sampling: A healthcare provider may diagnose leishmaniasis by examining tissue samples from the body for the presence of Leishmania parasites. These samples can include tissue from ulcers, the spleen, or other affected areas [1].
• Leishmania Skin Testing: However, it's worth noting that Leishmania skin testing is not recommended or available in the United States or Canada due to a lack of standardized and approved tests [2].
• Real-Time PCR Tests: Qualitative diagnostic real-time PCR tests, such as SMART Leish, can be used to detect Leishmania species from individuals suspected of having leishmaniasis [3].
• Aldehyde and Antimony Tests: Historically, the aldehyde test and antimony test were used to detect hypogammaglobinemia and diagnose visceral leishmaniasis [4].
• Immunodiagnosis: Immunodiagnostic tests can detect antigens or anti-Leishmania antibodies in serum or urine samples from patients, providing a reliable method for diagnosing leishmaniasis [5].
• Rapid Diagnostic Tests: Rapid diagnostic tests, such as the CL Detect Rapid Test, have been developed to diagnose post-kala-azar dermal leishmaniasis with high sensitivity and specificity [6].
• Serological Methods: Serological methods can detect antigens or antileishmanial antibodies in blood, urine, or saliva, providing a useful tool for diagnosing leishmaniasis [7].
• Skin Scraping and Biopsy: When faced with a possible leishmanial skin lesion, a skin scraping with microscopic analysis is the best test. Punch biopsies with tissue- examination can also be used to confirm the diagnosis [8].

These diagnostic tests are essential for identifying leishmaniasis and providing timely treatment to patients.

References:

[1] Context result 1 [2] Context result 2 [3] Context result 3 [4] Context result 4 [5] Context result 5 [6] Context result 9 [7] Context result 7 [8] Context result 8

Treatment Options for Leishmaniasis

Leishmaniasis, a disease caused by the Leishmania parasite, can be treated with various medications. The treatment options vary depending on the type and severity of the disease.

• Intravenous Liposomal Amphotericin B (L-AmB): This is the only FDA-approved medication for the treatment of visceral leishmaniasis (VL). It is a first-line treatment option for VL, especially in cases where the parasite has developed resistance to other medications [6].
• Amphotericin B: This medication is also used to treat VL and cutaneous leishmaniasis. It can be administered intravenously or intramuscularly [7].
• Miltefosine: This oral agent was approved by the FDA in 2014 for the treatment of CL, ML, and VL caused by certain Leishmania species [1]. It is a second-line treatment option for VL.
• Pentavalent Antimonials (SbV): These have been the preferred treatment worldwide for many decades. However, increased drug resistance and significant side effects have limited their use [8].
• Paromomycin: This medication has been used to treat VL, but its effectiveness is variable and it can cause significant side effects [4].
• Pentamidine: This is a first-line medication in cutaneous leishmaniasis except for L mexicana. It is also used to treat VL, especially in cases where the parasite has developed resistance to other medications [5].

References:

[1] Mar 13, 2024 — In 2014, FDA approved the oral agent miltefosine for treatment of CL, ML, and VL caused by particular Leishmania species (see below for details) ...

[2] by S Pradhan · 2022 · Cited by 104 — Existing drugs repurposed for leishmaniasis include amphotericin B, miltefosine, paromomycin and petamidine. Azole antifungals have also studied for ...

[3] What medications treat leishmaniasis? Medications providers use to treat leishmaniasis include: Amphotericin. Miltefosine. Pentavalent antimonials, such as ...

[4] by EM Moore · 2010 · Cited by 252 — The main drugs available for treatment of VL are the systemic agents like antimony, amphotericin, paromomycin and now the oral drug miltefosine. All these drugs ...

[5] Oct 23, 2024 — Pentamidine is a first-line medication in cutaneous leishmaniasis except for L mexicana (ketoconazole 600 mg PO qd for 28 d). It is a treatment ...

[6] by N Aronson · 2017 · Cited by 800 — The only Food and Drug Administration (FDA)-approved medications for the treatment of leishmaniasis are intravenous liposomal amphotericin B (L-AmB) for VL ...

[7] Jan 30, 2023 — For many decades most patients have been treated with intravenous or intramuscular injection of antimonials as the first line therapy.

[8] by S Sundar · 2024 · Cited by 3 — Pentavalent antimonials (SbV) have long been the preferred treatment worldwide but increased drug resistance, and significant side effects, including ...

[9] by SY Sheikh · 2024 · Cited by 6 — Leishmaniasis is typically treated with a range of medications, including amphotericin B and miltefosine. In 2007 and 2008, the World Health Organization (WHO) ...

Differential Diagnosis of Leishmaniasis

Leishmaniasis, a disease caused by an intracellular protozoa parasite transmitted by the bite of a female sandfly, can mimic various other conditions, making differential diagnosis challenging. The clinical features of leishmaniasis resemble those of other commonly occurring diseases such as tuberculosis, typhoid, and malaria.

Conditions to Consider in Differential Diagnosis

• Bacterial skin infections: Leishmaniasis can present with skin lesions that may be mistaken for bacterial infections.
• Blastomycosis: This fungal infection can cause skin lesions similar to those seen in leishmaniasis.
• Other fungal skin infections: Fungal infections such as histoplasmosis and coccidioidomycosis can also present with skin lesions that may be confused with leishmaniasis.
• Eczema: The skin lesions caused by leishmaniasis can be mistaken for eczema, especially in non-endemic areas.
• Leprosy: Leprosy, a chronic bacterial infection, can cause skin lesions and nerve damage that may be confused with leishmaniasis.
• Sarcoidosis: This autoimmune disease can cause skin lesions and other symptoms that may resemble those of leishmaniasis.
• Syphilis: The primary stage of syphilis can present with a single, painless chancre (ulcer) on the skin or mucous membranes, which may be mistaken for a leishmaniasis lesion.

Laboratory Methods for Differential Diagnosis

Reliable laboratory methods are essential for differentiating leishmaniasis from other conditions. These include:

• Culture: Culturing the parasite in a laboratory can confirm the diagnosis of leishmaniasis.
• Histologic examination: Examining tissue samples under a microscope can help identify the presence of the parasite and rule out other conditions.
• Polymerase chain reaction (PCR) study: PCR is a sensitive test that can detect the genetic material of the parasite, confirming the diagnosis of leishmaniasis.

Conclusion

Differential diagnosis of leishmaniasis requires careful consideration of various conditions that may mimic its clinical features. Reliable laboratory methods are essential for differentiating leishmaniasis from other conditions and ensuring accurate diagnosis and treatment.

Citations:

• [1] Reference 1
• [2] Reference 2