Leishmaniasis

Leishmaniasis refers to zoonoses caused by parasites of the genus Leishmania. There are three main forms of leishmaniasis: visceral (also known as kala-azar or dum-dum fever), cutaneous, and mucocutaneous.

Epidemiology

Leishmaniasis is a truly global disease with a higher burden in the tropical regions of Africa, Asia and Latin America. The disease was once thought to be non-existent in Australia, however cases have been reported ^1,2. Globally the incidence of new disease was recently reported as a million cases a year ³, however precise numbers are impossible to calculate as the disease tends to affect the penurious in resource-poor countries.

Clinical presentation

Clinical presentation depends upon the type of leishmaniasis, although there is overlap between the forms:

• visceral leishmaniasis
  • fever
  • hepatosplenomegaly
  • skin disease may be seen
• cutaneous leishmaniasis (includes mucocutaneous form)
  • ulcerating skin lesions
  • +/- visceral sequelae in immunocompromised hosts

Pathology

Tiny insects called sandflies act as vectors for the pathogenic Leishmaniasis spp. are carried by a vector of  to mammals including humans. Leishmania are intracellular protozoan parasites. Potentially fatal species include L. donavi and L. infantum. 

Radiographic features

Visceral leishmaniasis causes splenomegaly that is not always distinct from other forms of splenomegaly. Reported cases suggest that multiple nodular lesions in the spleen may occur ^4-6.