Leishmaniasis – Causes, Symptoms and Treatments!

Leishmaniasis – Causes, Symptoms and Treatments that we should not ignore. In addition, we use the term leishmaniasis to define a set of diseases caused by parasites of the genus Leishmania. These parasites are present on almost all continents, with the exception of Australia and Antarctica, and more than 20 species have already been identified.

Leishmaniasis is characterized by the WHO (world health organization) as one of the six most important infectious diseases in the world. It is estimated that around 2 million people are affected every year.

Despite the immense number of infected patients, Leishmaniasis is considered a neglected disease by the pharmaceutical industry, as it affects mostly disadvantaged populations, that is, with less purchasing power and less potential to generate profits for these companies. In Brazil, leishmaniasis is present in all states.

Causes of Leishmaniasis:  Although cases of inter-human transmission (blood transfusion, organ transplantation or intravenous drug use) have been described, leishmaniasis is a disease that is normally transmitted through sandflies that were previously infected by biting infected animals or humans. .

Several mammals, both domestic and wild (rodents, dogs, cats, rats, anteaters, sloths, skunks) were identified as natural reservoirs (they have a host and transmit the parasite, although they are not affected by the disease). Leishmaniasis has a global distribution and affects about 90 countries in South America, Central America, Europe, Africa and Asia.

A distinction is often made between Old World (Europe, Asia and Africa) and New World (America) leishmaniasis .

Symptoms of Leishmaniasis:  After the bite, the parasites multiply at the site, giving rise to a lesion with raised edges. Often these are located in places like the face and extremities. From this lesion, the parasites can end up reaching the mucous membranes of the mouth or nose. In many cases, ulcers form on these mucous membranes, even leading to local disfigurement.

The parasites can also spread and reach organs as diverse as the spleen, liver and bone marrow. In this more advanced stage of the disease some of the characteristic symptoms are;

• weakness ;
• Loss of appetite ;
• Pallor;
• Breathing problems;
• Bleeding in the mouth;
• Enlarged spleen;
• anemia ;
• slimming;
• diarrhea ;
• Bleeding in the intestine;
• Liver enlargement;
• Fever;
• Bone marrow involvement;

Leishmaniasis cases that are not treated can acquire serious contours and easily lead to death. Patients with HIV or other immunocompromised patients need extra attention, as reactivation of the disease is frequent even after treatment.

Diagnosis of Leishmaniasis:  The finding of parasites in the tissues of patients is one of the main evidences of a case of leishmaniasis . The disease can generate characteristic skin lesions, mucosal ulcers and serious complications in organs such as the spleen, liver and even bone marrow.

In this way, laboratory tests such as antibody research, tissue culture and small biopsies can be performed.

Taking into account the patient’s clinical condition, the doctor already suspects something. The most requested test is the blood test for antibody analysis. Serological tests are also widely performed, as are bone marrow punctures.

The correct diagnosis is very important, since this disease has symptoms very similar to, for example, malaria , typhoid fever , Chagas disease and schistosomiasis.

Therefore, a differential diagnosis must be performed so that the most appropriate treatment can begin. Once the disease is controlled, the symptoms regress, but they can reappear up to six months after the end of treatment.

Treatment of Leishmaniasis:  The drugs of first choice for the treatment of Leishmaniasis are Pentavalent Antimonials. They must be administered parenterally (ie, intramuscularly or intravenously) for a minimum period of 20 days. The dose and duration of therapy vary with the forms of the disease and severity of symptoms.

Its main side effect is the induction of cardiac arrhythmias and it is contraindicated in pregnant women in the first 2 trimesters, patients with hepatic and renal failure and in those using anti-arrhythmic drugs. Other drugs used in the treatment of leishmaniasis include amphotericin B, paromomycin and pentamidine.