Treatment and Control Measures of Leishmaniasis
Leishmaniasis is rare in the United States but has been reported in areas bordering Mexico such as rural southern Texas.
Most of the cases found in the United States are acquired elsewhere such as in travelers to Latin America.
More recently, more than 500 cases of leishmaniasis were diagnosed over an 18-month period in soldiers returning to the United States from the Middle East, especially from Iraq.
A large portion of these was identified as cutaneous leishmaniasis.
Cutaneous leishmaniasis is becoming a frequently encountered problem in soldiers returning from deployments to areas in Southwest Asia.
Two cases of cutaneous leishmaniasis diagnosed at a military treatment facility in soldiers returning from Iraq are presented.
Diagnostic considerations and procedures are reviewed as are the histopathologic findings and treatment options.
Leishmaniasis is divided into four main clinical forms and is caused by parasitic protozoa of the genus Leishmania.
There are over 20 species and subspecies that infect humans via the bite of sandflies (subfamily phlebotominae) - tiny sand-coloured blood-feeding flies that breed in forest areas, caves and burrows in tropical and subtropical regions.
The clinical features of the disease depend on the causative species and can range from simple, self-healing skin sores as found in cutaneous leishmaniasis (due to infection with Leishmania major), to severe, life-threatening disease of untreated visceral leishmaniasis caused by Leishmania donovani.
Leishmaniasis is a disease caused by protozoan parasites that belong to the genus Leishmania and is transmitted by the bite of certain species of sand fly, including flies in the genus Lutzomyia in the New World and Phlebotomus in the Old World.
Visceral Leishmaniasis has gained notoriety as an important opportunistic infection in persons with AIDS in Spain, southern France and Italy.
Before the introduction of HIV infections, it was encountered primarily in children (infantile splenomegaly) and adults immunocompromised by cancer or immunosuppressive therapy in the Mediterranean region A chronic disease caused by leishmania donovani and transmitted by the bite of several sandflies of the genera Phlebotomus and Lutzomyia.
It is commonly characterized by fever, chills, vomiting, anemia, hepatosplenomegaly, leukopenia, hypergammaglobulinemia, emaciation, and an earth-gray color of the skin.
The disease is classified into three main types according to geographic distribution: Indian, Mediterranean (or infantile), and African.
Epidemiology, disease patterns, immunology, diagnosis, treatment and control measures of leishmaniasis are described.
Various issues relating to leishmaniasis are highlighted: the relative lack of importance given to this disease is compared with other infections, climate change and its possible effect on extension of endemicity of this infection, and new diagnostic tests that are helping better diagnosis, especially in resource-poor areas.
Other important aspects discussed include the potential for newer oral treatment to change the way this disease is managed; leishmania-HIV coinfection and groups at risk; and the development of an effective vaccine.
Most of the cases found in the United States are acquired elsewhere such as in travelers to Latin America.
More recently, more than 500 cases of leishmaniasis were diagnosed over an 18-month period in soldiers returning to the United States from the Middle East, especially from Iraq.
A large portion of these was identified as cutaneous leishmaniasis.
Cutaneous leishmaniasis is becoming a frequently encountered problem in soldiers returning from deployments to areas in Southwest Asia.
Two cases of cutaneous leishmaniasis diagnosed at a military treatment facility in soldiers returning from Iraq are presented.
Diagnostic considerations and procedures are reviewed as are the histopathologic findings and treatment options.
Leishmaniasis is divided into four main clinical forms and is caused by parasitic protozoa of the genus Leishmania.
There are over 20 species and subspecies that infect humans via the bite of sandflies (subfamily phlebotominae) - tiny sand-coloured blood-feeding flies that breed in forest areas, caves and burrows in tropical and subtropical regions.
The clinical features of the disease depend on the causative species and can range from simple, self-healing skin sores as found in cutaneous leishmaniasis (due to infection with Leishmania major), to severe, life-threatening disease of untreated visceral leishmaniasis caused by Leishmania donovani.
Leishmaniasis is a disease caused by protozoan parasites that belong to the genus Leishmania and is transmitted by the bite of certain species of sand fly, including flies in the genus Lutzomyia in the New World and Phlebotomus in the Old World.
Visceral Leishmaniasis has gained notoriety as an important opportunistic infection in persons with AIDS in Spain, southern France and Italy.
Before the introduction of HIV infections, it was encountered primarily in children (infantile splenomegaly) and adults immunocompromised by cancer or immunosuppressive therapy in the Mediterranean region A chronic disease caused by leishmania donovani and transmitted by the bite of several sandflies of the genera Phlebotomus and Lutzomyia.
It is commonly characterized by fever, chills, vomiting, anemia, hepatosplenomegaly, leukopenia, hypergammaglobulinemia, emaciation, and an earth-gray color of the skin.
The disease is classified into three main types according to geographic distribution: Indian, Mediterranean (or infantile), and African.
Epidemiology, disease patterns, immunology, diagnosis, treatment and control measures of leishmaniasis are described.
Various issues relating to leishmaniasis are highlighted: the relative lack of importance given to this disease is compared with other infections, climate change and its possible effect on extension of endemicity of this infection, and new diagnostic tests that are helping better diagnosis, especially in resource-poor areas.
Other important aspects discussed include the potential for newer oral treatment to change the way this disease is managed; leishmania-HIV coinfection and groups at risk; and the development of an effective vaccine.
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