Leishmaniasis.
In 1903, Leishman and Donovan separately described the protozoan now called Leishmania donovani in splenic tissue from patients in India with the life-threatening disease now called visceral leishmaniasis. Almost a century later, many features of leishmaniasis and its major syndromes (ie, visceral, cutaneous, and mucosal) have remained the same; but also much has changed. As before, epidemics of this sandfly-borne disease occur periodically in India and elsewhere; but leishmaniasis has also emerged in new regions and settings, for example, as an AIDS-associated opportunistic infection. Diagnosis still typically relies on classic microbiological methods, but molecular-based approaches are being tested. Pentavalent antimony compounds have been the mainstay of antileishmanial therapy for half a century, but lipid formulations of amphotericin B (though expensive and administered parenterally) represent a major advance for treating visceral leishmaniasis. A pressing need is for the technological advances in the understanding of the immune response to leishmania and the pathogenesis of leishmaniasis to be translated into field-applicable and affordable methods for diagnosis, treatment, and prevention of this disease.
Herwaldt
B L
BL
Centers for Disease Control and Prevention, Division of Parasitic Diseases, Atlanta, GA 30341-3724, USA. bxh4@cdc.gov
D000666:Amphotericin B / Q000627:therapeutic use; D000818:Animals; D000965:Antimony / Q000627:therapeutic use; D000981:Antiprotozoal Agents / Q000627:therapeutic use*; D004334:Drug Administration Schedule; D005260:Female; D015658:HIV Infections / Q000150:complications; D006801:Humans; D007891:Leishmania / Q000302:isolation & purification; D007896:Leishmaniasis / Q000175:diagnosis / Q000188:drug therapy* / Q000276:immunology / Q000635:transmission; D016773:Leishmaniasis, Cutaneous / Q000175:diagnosis / Q000188:drug therapy; D007897:Leishmaniasis, Mucocutaneous / Q000175:diagnosis / Q000188:drug therapy; D007898:Leishmaniasis, Visceral / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy; D008297:Male
D000981:Antiprotozoal Agents; D000666:Amphotericin B; D000965:Antimony