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 la ter, 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 In dia and elsewhere; but leishmaniasis has also emerged in new regions and se ttings, for example, as an AIDS-associated opportunistic infection. Diagnos is still typically relies on classic microbiological methods, but molecular -based approaches are being tested. Pentavalent antimony compounds have bee n the mainstay of antileishmanial therapy for half a century, but lipid for mulations 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 translat ed into field-applicable and affordable methods for diagnosis, treatment, a nd prevention of this disease.