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TM: Leishmania (i) (Intro (invertebrate arthropod vector (intermediate…
TM: Leishmania (i)
Intro
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clinical spectrum can range from insignificant pustules (red, granulation tissue, painless hence you know it's not art/venous) to fatal systemic disease
reservoirs (hosts): vertebrates - humans (anthroponotic forms), animals (zoonotic forms)
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Cut
chronic skin ulcers
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face most commonly, ear, fingertip (exposed skin)
dDx
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fungal infection (coccioidmycosis, histoplasma)
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skin cancer (melanoma, SCC, BCC)
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90% occurs in Afghanistan, Brazil, Iran, Peru, Saudi Arabia
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Tx
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if severe...
pentavalent antimonials
SEs: pain, reversible hep, pancreatitis, cardiotoxicity
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alternatives
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other oral azoles (ketoconazole, itraconazole)
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Mucocut
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90% occurs in Bolivia, Brazil + Peru
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Lifecycle
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promastigotes get phagocytosed by macrophages / monocytes / phagocytic cells + transform into amastigotes (intracellular form)
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amastigotes transform to promastigotes in the fly's gut, which then migrate to the proboscis