Leishmania species is a topic covered in the Johns Hopkins Antibiotic (ABX) Guide.

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MICROBIOLOGY

  • Protozoan parasite of Kinetoplastid family, amastigote form infects macrophages.
  • Transmitted by various species of infected sandfly; also by needle sharing among IDUs in endemic regions. Lifecycle: Fig 1.
  • HIV increases risk of visceral (hepato/splenic and bone marrow) disease, not opportunistic cutaneous or mucocutaneous disease. Second most common opportunistic infection of tissue protozoan in HIV after Toxoplasma gondii worldwide.
  • Forms:
    • Visceral leishmaniasis: L. donovani (Asia), L. infantum (southern Europe, Mediterranean), L. chagasi (Brazil).
      • 90% of human visceral infections occur in India, Bangladesh, Nepal, Sudan, Ethiopia and Brazil.
    • Cutaneous leishmaniasis: L. major and L. tropica (Old World), L. mexicana, L. amazonensis, L. peruviana, L. guyanensis (New World), L. (viania) braziliensis (cutaneous and mucocutaneous).
      • 90% of human cutaneous infections occur in Afghanistan, Algeria, Iran, Saudi Arabia, Syria, Brazil, Colombia, Peru and Bolivia.

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Last updated: May 29, 2016