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Leishmaniasis

Kala-azar; Cutaneous leishmaniasis; Visceral leishmaniasis; Old world leishmaniasis; New world leishmaniasis

Leishmaniasis is an infectious disease spread by the bite of the female sandfly.

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Leishmaniasis
Leishmaniasis, mexicana - lesion on the cheek
Leishmaniasis on the finger
Leishmania panamensis on the foot
Leishmania panamensis - close-up

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Causes

Leishmaniasis is caused by a tiny parasite called leishmania protozoa. Protozoa are one-celled organisms.

The different forms of leishmaniasis are:

Cases of leishmaniasis have been reported on all continents except Australia and Antarctica. In the Americas, the disease can be found in Mexico and South America. It has also been reported in military personnel who have returned from the Persian Gulf.

Symptoms

Symptoms of cutaneous leishmaniasis depend on where the lesions are located and may include:

Systemic visceral infection in children usually begins suddenly with:

Adults usually have a fever for 2 weeks to 2 months, along with symptoms such as fatigue, weakness, and appetite loss. Weakness increases as the disease gets worse.

Other symptoms of systemic visceral leishmaniasis may include:

Exams and Tests

Your health care provider will examine you and may find that your spleen, liver, and lymph nodes are enlarged. You will be asked if you recall being bitten by sandflies or if you've been in an area where leishmaniasis is common.

Tests that may be done to diagnose the condition include:

Other tests that may be done include:

Treatment

Antimony-containing compounds are the main medicines used to treat leishmaniasis. These include:

Other medicines that may be used include:

Plastic surgery may be needed to correct the disfigurement caused by sores on the face (cutaneous leishmaniasis).

Outlook (Prognosis)

Cure rates are high with the proper medicine, mostly when treatment is started before it affects the immune system. Cutaneous leishmaniasis may lead to disfigurement.

Death is usually caused by complications (such as other infections), rather than from the disease itself. Death often occurs within 2 years.

Possible Complications

Leishmaniasis may lead to the following:

When to Contact a Medical Professional

Contact your provider if you have symptoms of leishmaniasis after visiting an area where the disease is known to occur.

Prevention

Taking measures to avoid sandfly bites can help prevent leishmaniasis:

Public health measures to reduce sandflies are important. There are no vaccines or medicines that prevent leishmaniasis.

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References

Aronson NE, Copeland NK, Magill AJ. Leishmania species: visceral (kala-azar), cutaneous, and mucosal leishmaniasis. In: Bennett JE, Dolin R, Blaser MJ, eds. Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases. 9th ed. Philadelphia, PA: Elsevier; 2020:chap 275.

Dinulos JGH. Infestations and bites. In: Dinulos JGH, ed. Habif's Clinical Dermatology. 7th ed. Philadelphia, PA: Elsevier; 2021:chap 15.

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Review Date: 8/26/2023  

Reviewed By: Jatin M. Vyas, MD, PhD, Associate Professor in Medicine, Harvard Medical School; Associate in Medicine, Division of Infectious Disease, Department of Medicine, Massachusetts General Hospital, Boston, MA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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