Leishmaniasis

Alternative Names

Symptoms

Systemic visceral infection in children usually begins suddenly with vomiting, diarrhea, fever, and cough. Adults usually have a fever for 2 weeks to 2 months, along with nonspecific symptoms such as fatigue, weakness, and loss of appetite. Weakness increases as the disease gets worse.

Other symptoms of systemic visceral leishmaniasis may include:

• Cough (children)
• Diarrhea (children)
• Fever that persists for weeks; may come and go in cycles
• Night sweats
• Scaly, gray, dark, ashen skin
• Thinning hair
• Vague belly area (abdominal) discomfort
• Vomiting (children)
• Weight loss

Cutaneous leishmaniasis affects the skin and mucuous membranes. Symptoms may include:

• Breathing difficulty
• Skin sores (macule or papule)
• Skin ulcer (forms at site of original sore); ulcer heals very slowly
• Smaller lesions may form around the ulcer (satellite lesions)
• Stuffy nose, runny nose, and nosebleeds
• Swallowing difficulty
• Ulcers and wearing away (erosion) of tissues on the mouth, tongue, gums, lips, nose, and inner nose

Exams and Tests

A physical exam may show signs of an enlarged spleen, liver, and lymph nodes. The patient may have a history of being bit by sandflies or being in an area known for leishmaniasis.

Tests that may be done to diagnose the condition include:

• Biopsy of the spleen and culture to see if microorganisms grow
• Bone marrow biopsy and culture to see if microorganisms grow
• Direct agglutination assay
• Indirect immunofluorescent antibody test
• Lymph node biopsy and culture to see if microorganisms grow
• Montenegro skin test
• Skin biopsy

Other tests that may be done include:

• Complete blood count
• Hemoglobin
• Immunoglobulins
• Serum protein
• Serum albumin

References

Reithinger R. Cutaneous leishmaniasis. Lancet Infect Dis. Sep 2007; 7(9): 581-96.