Leishmaniasis

Question 1

Explain the life cycle of Leishmaniasis

Answer 1

Sand flies bite dogs, humans

• infect during blood meal
• parasite phagocytized by macrophages
• parasite in blood called amastigote
• multiply in skin or organs
• sand flies re-infect if they bite

Question 2

What are the clinical manifestations of VISCERAL Leishmaniasis?

Answer 2

Visceral Leishmaniasis:

• Systemic fever, weight loss
• death due to secondary bacterial/viral infection
• opportunistic infection in immunosuppressed

Question 3

What are the clinical manifestations of CUTANEOUS (military) Leishmaniasis?

Answer 3

CUTANEOUS:

• chronic skin lesions (possibly ulcerative, single or many)
• heal down the road with scarring
• volcano phase with raised edges

Question 4

What are the clinical manifestations of MUCOSAL Leishmaniasis?

Answer 4

MUCOSAL:

-metastatic ulcerative mucosal lesions can develop in mouth or airway

Question 5

How do you diagnose Leishmaniasis?

Answer 5

Microscopic biopsy or slides of infectious tissue, looking for amastigotes

• Skin biopsy in cutaneous
• Bone marrow or liver in visceral
• Serum Ab in reference lab
• PCR

Question 6

How do you treat Leishmaniasis?

Answer 6

Look up and punt

Question 7

How do you prevent Leishmaniasis?

Answer 7

• Reduce sand fly bites (netting, housing, repellents)
• Reduce animal reservoir (wild dogs)
• no vaccine or chemoprophylaxis

Question 8

In what populations is Leishmaniasis most commonly found?

Answer 8

Returning military personnel

• Common globally
• Less common in US