title: Leishmaniasis: diagnostic issues in Europe.
abstract: Leishmaniasis is a parasitic disease with clinical presentations that vary from asymptomatic infection to cutaneous, mucocutaneous or visceral disease. Recent epidemiological studies have shown an increased prevalence in Europe largely caused by an increase in international travel, difficulty eradicating leishmanial infection in AIDS patients, and the use of immunosuppressive medications. Clinical diagnosis may be challenging, and parasitological diagnosis entails the use of invasive procedures which may be unrevealing in the immunosuppressed. A number of less invasive tests for the detection of anti-leishmanial antibodies or leishmanial antigen are available but their sensitivity and specificity may vary with the infective species and results have to be interpreted in light of the clinical presentation. The availability of polymerase chain reaction assays amplifying leishmanial genetic material has been a major step forward in improving the diagnosis of leishmanial disease and the response to treatment.
authors.affiliation: Department of Child and Adolescent Health, Mater Dei Hospital, Tal-Qroqq, Msida, MSD 2090, Malta.
authors.forename: Paul
authors.initials: P
authors.lastname: Torpiano
authors.forename: David
authors.initials: D
authors.lastname: Pace
mesh_terms: D000981:Antiprotozoal Agents / Q000494:pharmacology / Q000627:therapeutic use; D005060:Europe; D006801:Humans; D007891:Leishmania / Q000187:drug effects / Q000302:isolation & purification*; D007896:Leishmaniasis / Q000175:diagnosis* / Q000188:drug therapy / Q000453:epidemiology*; D016133:Polymerase Chain Reaction / Q000379:methods
chemical_list: D000981:Antiprotozoal Agents
keywords: Europe; anti-leishmanial antibodies; cutaneous leishmaniasis; leishmania PCR; parasitological diagnosis; visceral leishmaniasis