Medical Microbiology

Leishmania 495

Table9. 4 SelectedFormsofLeishmaniosesinHumans

(L.:subgenusLeishmania,V.:subgenusViannia)

Visceralleishmanioses^1

Mainlocalization: Internalorgans,lessoftenskin.

Incubation: Inmostcases 3 – 6 months,also:severalweekstoyears

Primarysymptoms: Fever,splenomegaly,hypergammaglobulinemia,progressive

anemia,leucopeniaetc.

&L.(L.)donovani: Asia:India,Bangladesh,southernNepal.Mainlyinadults.

Reservoirhosts^2 :humans.Vectors:Phlebotomusspecies.

&L.(L.)donovani: Africa:MainlySudan,Ethiopia,Kenya.Reservoirhosts:

humans,dogs(Felidae,rodents?)^2 .Vectors:Phlebotomus

species.

&L.(L.)infantum: Mediterraneanregion(IberianPeninsulatoTurkey,northern

Africa),MiddleEastandcentralAsia,China.Inchildrenand

adults;inadultscutaneousmanifestationsaswell:Reservoir

hosts:humans,dogs,wildCanidae.Vectors:Phlebotomus

species.

&L.(L.)chagasi^3 : CentralandnorthernSouthAmerica.Mainlyinyouths.

Reservoirhosts:humans,dogs,foxspecies,(opossum?).

Vectors:Lutzomyiaspecies.

Cutaneousleishmanioses(orientalsore)

Mainlocalization: Skin.

Incubation: Weekstomonths.

Primarysymptoms: OnskinaccessiblebyPhlebotomusspecies,developmentof

solitaryormultiple,dry,laterpossiblyulceratingpapules;

rarelyspreadtolymphvesselsandnodes.Healingwith

scarification.Solidimmunityisconferredbyinfectionswith

L.majorandL.tropica.

&L.(L.)major: NorthernAfrica,MiddleEast,SahelZone,westernAsia.

Incubation:upto 2 months.“Moist,”(=“rural,”or“zoonotic”)

form.Rapidgrowthofcutaneouslesion,laterulcerationand

healingwithin 6 months.Reservoirhosts:rodents.

Vectors:Phlebotomusspecies.

&L.(L.)tropica: Mediterraneanregion,southwesternAsiatoIndia.

Incubation: 2 – 24 months.“Dry,”(=“urban,”or

“anthroponotic”)form.Developmentoflesionsand

persistencelongerthanwithL.major.Reservoirhosts:

humans.Vectors:Phlebotomusspecies.

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Kayser, Medical Microbiology © 2005 Thieme