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  icon Low morbidity
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ICD-9 : 085.9 • ICD-10 : B55   Image not available. Image not available. Image not available. Image not available.


  • Etiology: many species of obligate intracellular protozoa Leishmania; predominant species are:
    • Old World: L. tropica,L. major,L. aethiopica
    • New World: L. Mexican complex, Viannia subgenus
  • Vector: sandflies
    • Old World: Plebotomus
    • New World: Luzomyia
  • Infection of macrophages in skin (dermis), nasooropharyngeal mucosa, and the reticuloendothelial system (viscera)
  • Diversity of clinical syndromes due to particular parasite, vector, and host species.
  • Clinical syndromes: cutaneous, mucosal, visceral
    • Cutaneous leishmaniasis (CL) characterized by development of single or multiple cutaneous papules at the site of a sandfly bite, often evolving into nodules and ulcers, which heal spontaneously with a depressed scar
      • Old World cutaneous leishmaniasis (OWCL)
      • New World cutaneous leishmaniasis (NWCL)
    • Diffuse (anergic) cutaneous leishmaniasis (DCL)
    • Mucosal leishmaniasis (ML)
    • Visceral leishmaniasis (VL); kala-azar; post–kala-azar dermal leishmaniasis (PKDL)
  • Management: parenteral antimonials for significant disease




  • OWCL: Baghdad/Delhi boil or button, oriental/Aleppo sore/evil, bouton d'Orient.
  • NWCL: chiclero ulcer, pian bois (bush yaws), uta.
  • ML: Espundia.
  • VL: Kala-azar (Hindu for black fever)






Infection in humans is caused by ∼20 Leishmania species (Leishmania and Viannia subgenera). See Table 29-1.

Table Graphic Jump Location
Table 29-1 Leishmania Species that Cause Disease in Humans

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