What are the diagnostic considerations in leishmaniasis?

Updated: Feb 18, 2020
  • Author: Craig G Stark, MD, FACP, FFTM, RCPS(Glasg), FISTM; Chief Editor: Pranatharthi Haran Chandrasekar, MBBS, MD  more...
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Answer

As noted earlier, infection with different Leishmania species can lead to a remarkably broad range of disease states. The clinical spectrum can range from insignificant pustules to fatal systemic disease. General understanding of this clinical spectrum, although once believed to be quite predictable, continues to evolve as new diagnostic techniques contribute to the elucidation of the variety of clinical manifestations of an infection with even a single species of Leishmania.

Coexisting infectious diseases and/or nutritional deficiencies may significantly impact the severity and outcome of leishmanial infection. In southern Europe along the Mediterranean, visceral leishmaniasis is emerging most notably as a serious opportunistic infection in individuals with human immunodeficiency virus (HIV) infection, where most adult patients (< 70%) with visceral leishmaniasis have late-stage acquired immunodeficiency syndrome (AIDS). Individuals with HIV infection and leishmaniasis have higher parasite loads, poorer responses to skin testing, lower responses to pentavalent antimony, and higher posttreatment relapse rates than those of their immunocompetent counterparts. [15]


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