Leishmaniasis causes

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Alejandro Lemor, M.D. [2]

Overview

Leishmaniasis is a vector-borne disease that is transmitted by sandflies and caused by obligate intracellular protozoa of the genus Leishmania. Human infection is caused by about 21 of 30 species that infect mammals. These include the L. donovani complex with 2 species (L. donovani,L. infantum [also known as L. chagasi in the New World]); the L. mexicana complex with 3 main species (L. mexicana, L. amazonensis, and L. venezuelensis); L. tropica; L. major; L. aethiopica; and the subgenus Viannia with 4 main species (L. (V.) braziliensis, L. (V.) guyanensis, L. (V.) panamensis, and L. (V.) peruviana). The different species are morphologically indistinguishable, but they can be differentiated by isoenzyme analysis, molecular methods, or monoclonal antibodies.

Causes

Etiology by Disease Form

Cutaneous Leishmaniasis

• Different Leishmania species cause Old World versus New World (American) cutaneous leishmaniasis.
• In the Old World (the Eastern Hemisphere), the etiologic agents include Leishmania tropica, L. major, and L. aethiopica, as well as L. infantum and L. donovani.
• The main species in the New World (the Western Hemisphere) are either in the L. mexicana species complex (L. mexicana, L. amazonensis, and L. venezuelensis) or the subgenus Viannia (L. [V.] braziliensis, L. [V.] guyanensis, L. [V.] panamensis, and L. [V.] peruviana).
• The Viannia subgenus is also referred to as the L. (V.) braziliensis species complex.

Mucosal Leishmaniasis

• Mucosal leishmaniasis is caused by species in the Viannia subgenus (especially L. [V.] braziliensis but also L. [V.] panamensis and sometimes L. [V.] guyanensis); it also can be caused by L. (Leishmania) amazonensis.

Visceral Leishmaniasis

• Visceral leishmaniasis usually is caused by the species L. donovani and L. infantum (L. chagasi generally is considered synonymous with L. infantum) and affects internal organs (particularly, spleen, liver, and bone marrow).