View source for Leishmaniasis

==Background==
[[File:Leishmaniasis life cycle diagram en.png|thumb|Life cycle]]
*Vector: sandfly
*Occurs sporadically in rural Africa, Asia, Mediterranean, Central/South America
*Wide variety of symptoms given numerous species of protozoa
*500,000 new cases and 60,000 deaths each year

==Clinical Features==
[[File:Leishmaniasis ulcer.jpg|thumb|Cutaneous leishmaniasis ulcer]]
===Cutaneous===
*Single to diffuse nodules/plagues with central clearing/eschar/fibrinous exudate

===Mucocutaneous===
*Mucosal destruction, deformity nasal blockage, bleeding, increased secretions, sloughing of dead tissue, dysphonia, odynophagia, respiratory distress

===Visceral (Kala-azar)===
*Darkening of skin, malaise, fever, weight lost, splenomegaly with advanced disease causing hepatic dysfunction, jaundice, ascites, thrombocytopenia, and hemorrhagic complications
**Anemia, neutropenia, [[thrombocytopenia]], [[hypoalbuminemia]], hyperbilirubinemia

==Differential Diagnosis==
*Cutaneous/Mucocutaneous-bacterial skin infection
*Malignancy
*Sarcoidosis
*Spider bite
*Tropical ulcer
*Yaws
*Cutaneous [[anthrax]]
*Nocardia and actinomycosis
*Cutaneous [[tuberculosis]]

{{Travel Skin Conditions DDX}}

==Evaluation==
*CBC
*Chem
*Histology
*Culture
*Bone marrow or spleen biopsy (for visceral form)
*PCR

==Management==
*Uncomplicated cutaneous leishmaniasis
**Topical [[Paromomycin]]
**Local injection of Stibogluconate or Meglumine antimoniate 
**Debridement of necrotic tissue
*Complicated cutaneous leishmaniasis
**PO [[Fluconazole]] or Miltefosine. 
**IV Stibogluconate, Meglumine, [[Amphotericin B]], or Pentamidine
*Visceral leishmaniasis
**[[Amphotericin B]], Stibogluconate

==Disposition==
*Discharge with infectious disease followup

==See Also==
*[[Travel Skin Conditions]]
*[[Parasitic Diseases]]

==References==
<References/>

[[Category:ID]]
[[Category:Tropical Medicine]]