Leishmaniasis Questions & Answers

1. World Health Organization. Leishmaniasis: the disease and its epidemiology. Available at http://www.who.int/leishmaniasis/disease_epidemiology/en/. Accessed: April 10, 2014.

2. Centers for Disease Control and Prevention. Parasites home: leishmaniasis. Epidemiology & risk factors. Available at http://www.cdc.gov/parasites/leishmaniasis/epi.html. Accessed: April 11, 2014.

3. Cardo LJ, Rentas FJ, Ketchum L, Salata J, Harman R, Melvin W, et al. Pathogen inactivation of Leishmania donovani infantum in plasma and platelet concentrates using riboflavin and ultraviolet light. Vox Sang. 2006 Feb. 90(2):85-91. [QxMD MEDLINE Link].

4. Cardo LJ, Salata J, Harman R, Mendez J, Weina PJ. Leukodepletion filters reduce Leishmania in blood products when used at collection or at the bedside. Transfusion. 2006 Jun. 46(6):896-902. [QxMD MEDLINE Link].

5. McHugh CP, Melby PC, LaFon SG. Leishmaniasis in Texas: epidemiology and clinical aspects of human cases. Am J Trop Med Hyg. 1996 Nov. 55(5):547-55. [QxMD MEDLINE Link].

6. Centers for Disease Control and Prevention. Parasites home: leishmaniasis. Resources for health professionals. Available at http://www.cdc.gov/parasites/leishmaniasis/health_professionals/. Accessed: April 10, 2014.

7. Magill AJ, Grogl M, Gasser RA Jr, Sun W, Oster CN. Visceral infection caused by Leishmania tropica in veterans of Operation Desert Storm. N Engl J Med. 1993 May 13. 328(19):1383-7. [QxMD MEDLINE Link].

8. Coleman RE, Burkett DA, Putnam JL, Sherwood V, Caci JB, Jennings BT, et al. Impact of phlebotomine sand flies on U.S. Military operations at Tallil Air Base, Iraq: 1. background, military situation, and development of a "Leishmaniasis Control Program". J Med Entomol. 2006 Jul. 43(4):647-62. [QxMD MEDLINE Link].

9. Myles O, Wortmann GW, Cummings JF, Barthel RV, Patel S, Crum-Cianflone NF, et al. Visceral leishmaniasis: clinical observations in 4 US army soldiers deployed to Afghanistan or Iraq, 2002-2004. Arch Intern Med. 2007 Sep 24. 167(17):1899-901. [QxMD MEDLINE Link].

10. Centers for Disease Control and Prevention. Update: Cutaneous leishmaniasis in U.S. military personnel--Southwest/Central Asia, 2002-2004. MMWR Morb Mortal Wkly Rep. 2004 Apr 2. 53(12):264-5. [QxMD MEDLINE Link].

11. Leishmaniasis Fact Sheet. World Health Organization. Available at http://www.who.int/mediacentre/factsheets/fs375/en/. 2016 Mar 01; Accessed: 2016 Mar 31.

12. Leishmaniasis - Global Health Observatory Data. World Health Organization. Available at http://apps.who.int/gho/data/node.main.NTDLEISH?lang=en. 2016 Mar 01; Accessed: 2016 Mar 31.

13. South-East Asia poised to defeat visceral leishmaniasis (kala-azar). WORLD HEALTH ORGANIZATION. Available at http://www.who.int/neglected_diseases/news/SEARO_poised_to_defeat_VL/en/. 2015 OCT 15; Accessed: 2016 MAR 31.

14. World Health Organization. Essential leishmaniasis maps: visceral and mucocutaneous leishmaniasis. April 10, 2014. [Full Text].

15. Martín-Ezquerra G, Fisa R, Riera C, Rocamora V, Fernández-Casado A, Barranco C, et al. Role of Leishmania spp. infestation in nondiagnostic cutaneous granulomatous lesions: report of a series of patients from a Western Mediterranean area. Br J Dermatol. 2009 Aug. 161(2):320-5. [QxMD MEDLINE Link].

16. Monno R, Giannelli G, Rizzo C, De Vito D, Fumarola L. Recombinant K39 immunochromatographic test for diagnosis of human leishmaniasis. Future Microbiol. 2009 Mar. 4(2):159-70. [QxMD MEDLINE Link].

17. Kubar J, Fragaki K. Recombinant DNA-derived leishmania proteins: from the laboratory to the field. Lancet Infect Dis. 2005 Feb. 5(2):107-14. [QxMD MEDLINE Link].

18. Zijlstra EE, Nur Y, Desjeux P, Khalil EA, El-Hassan AM, Groen J. Diagnosing visceral leishmaniasis with the recombinant K39 strip test: experience from the Sudan. Trop Med Int Health. 2001 Feb. 6(2):108-13. [QxMD MEDLINE Link].

19. Kumar R, Pai K, Pathak K, Sundar S. Enzyme-linked immunosorbent assay for recombinant K39 antigen in diagnosis and prognosis of Indian visceral leishmaniasis. Clin Diagn Lab Immunol. 2001 Nov. 8(6):1220-4. [QxMD MEDLINE Link].

20. Lemos EM, Carvalho SF, Corey R, Dietze R. [Evaluation of a rapid test using recombinant k39 antigen in the diagnosis of visceral leishmaniasis in Brazil]. Rev Soc Bras Med Trop. 2003. 36 Suppl 2:36-8. [QxMD MEDLINE Link].

21. Hartzell JD, Aronson NE, Weina PJ, Howard RS, Yadava A, Wortmann GW. Positive rK39 serologic assay results in US servicemen with cutaneous leishmaniasis. Am J Trop Med Hyg. 2008 Dec. 79(6):843-6. [QxMD MEDLINE Link].

22. Singh D, Pandey K, Das VN, Das S, Kumar S, Topno RK, et al. Novel noninvasive method for diagnosis of visceral leishmaniasis by rK39 testing of sputum samples. J Clin Microbiol. 2009 Aug. 47(8):2684-5. [QxMD MEDLINE Link]. [Full Text].

23. Alam MZ, Shamsuzzaman AK, Kuhls K, Schönian G. PCR diagnosis of visceral leishmaniasis in an endemic region, Mymensingh district, Bangladesh. Trop Med Int Health. 2009 May. 14(5):499-503. [QxMD MEDLINE Link].

24. Wortmann G, Hochberg L, Houng HH, Sweeney C, Zapor M, Aronson N, et al. Rapid identification of Leishmania complexes by a real-time PCR assay. Am J Trop Med Hyg. 2005 Dec. 73(6):999-1004. [QxMD MEDLINE Link].

25. Wall EC, Watson J, Armstrong M, Chiodini PL, Lockwood DN. Epidemiology of imported cutaneous leishmaniasis at the Hospital for Tropical Diseases, London, United Kingdom: use of polymerase chain reaction to identify the species. Am J Trop Med Hyg. 2012 Jan. 86(1):115-8. [QxMD MEDLINE Link]. [Full Text].

26. Zijlstra EE. Visceral leishmaniasis: a forgotten epidemic. Arch Dis Child. 2016 Feb 19. [QxMD MEDLINE Link].

27. Ozcan D, Seçkin D, Allahverdiyev AM, Weina PJ, Aydin H, Ozçay F, et al. Liver transplant recipient with concomitant cutaneous and visceral leishmaniasis. Pediatr Transplant. 2007 Mar. 11(2):228-32. [QxMD MEDLINE Link].

28. [Guideline] Kaplan JE, Benson C, Holmes KK, Brooks JT, Pau A, Masur H. Guidelines for prevention and treatment of opportunistic infections in HIV-infected adults and adolescents: recommendations from CDC, the National Institutes of Health, and the HIV Medicine Association of the Infectious Diseases Society of America. MMWR Recomm Rep. 2009 Apr 10. 58:1-207; quiz CE1-4. [QxMD MEDLINE Link].

29. [Guideline] AIDSinfo.com. Clinical guidelines portal. Guidelines for the prevention and treatment of opportunistic infections in HIV-infected adults and adolescents: what’s new in the guidelines. July 8, 2013. Available at http://aidsinfo.nih.gov/contentfiles/lvguidelines/adult_oi.pdf. Accessed: April 14, 2014.

30. Navin TR, Arana BA, Arana FE, Berman JD, Chajon JF. Placebo-controlled clinical trial of sodium stibogluconate (Pentostam) versus ketoconazole for treating cutaneous leishmaniasis in Guatemala. J Infect Dis. 1992 Mar. 165(3):528-34. [QxMD MEDLINE Link].

31. Wortmann G, Miller RS, Oster C, Jackson J, Aronson N. A randomized, double-blind study of the efficacy of a 10- or 20-day course of sodium stibogluconate for treatment of cutaneous leishmaniasis in United States military personnel. Clin Infect Dis. 2002 Aug 1. 35(3):261-7. [QxMD MEDLINE Link].

32. Sundar S, Chakravarty J, Agarwal D, Rai M, Murray HW. Single-dose liposomal amphotericin B for visceral leishmaniasis in India. N Engl J Med. 2010 Feb 11. 362(6):504-12. [QxMD MEDLINE Link].

33. Sundar S, Sinha PK, Rai M, et al. Comparison of short-course multidrug treatment with standard therapy for visceral leishmaniasis in India: an open-label, non-inferiority, randomised controlled trial. Lancet. 2011 Feb 5. 377(9764):477-86. [QxMD MEDLINE Link].

34. Sundar S, Agrawal G, Rai M, Makharia MK, Murray HW. Treatment of Indian visceral leishmaniasis with single or daily infusions of low dose liposomal amphotericin B: randomised trial. BMJ. 2001 Aug 25. 323(7310):419-22. [QxMD MEDLINE Link].

35. Avasthi R, Chaudhary SC, Khanna S. Visceral leishmaniasis simulating chronic liver disease: successful treatment with miltefosine. Indian J Med Microbiol. 2009 Jan-Mar. 27(1):85-6. [QxMD MEDLINE Link].

36. Ritmeijer K, Ter Horst R, Chane S, Aderie EM, Piening T, Collin SM, et al. Limited Effectiveness of High-Dose Liposomal Amphotericin B (AmBisome) for Treatment of Visceral Leishmaniasis in an Ethiopian Population With High HIV Prevalence. Clin Infect Dis. 2011 Oct 19. [QxMD MEDLINE Link].

37. Prasad R, Kumar R, Jaiswal BP, Singh UK. Miltefosine: an oral drug for visceral leishmaniasis. Indian J Pediatr. 2004 Feb. 71(2):143-4. [QxMD MEDLINE Link].

38. Impavido (miltefosine) prescribing information. [package insert]. Wilmington, DE: Paladin Therapeutics, Inc. 2014.

39. Sundar S, Jha TK, Thakur CP, et al. Oral miltefosine for the treatment of Indian visceral leishmaniasis. Trans R Soc Trop Med Hyg. 2006 Dec. 100 Suppl 1:S26-33. [QxMD MEDLINE Link].

40. Rahman M, Ahmed BN, Faiz MA, Chowdhury MZ, Islam QT, Sayeedur R, et al. Phase IV trial of miltefosine in adults and children for treatment of visceral leishmaniasis (kala-azar) in Bangladesh. Am J Trop Med Hyg. 2011 Jul. 85(1):66-9. [QxMD MEDLINE Link]. [Full Text].

41. Investigational Drug Available Directly from CDC for the Treatment of Infections with Free-Living Amebae. MMWR Morb Mortal Wkly Rep. 2013 Aug 23. 62(33):666. [QxMD MEDLINE Link].

42. Nacher M, Carme B, Sainte Marie D, Couppie P, Clyti E, Guibert P, et al. Influence of clinical presentation on the efficacy of a short course of pentamidine in the treatment of cutaneous leishmaniasis in French Guiana. Ann Trop Med Parasitol. 2001 Jun. 95(4):331-6. [QxMD MEDLINE Link].

43. Dogra J. Current therapies for treatment of cutaneous leishmaniasis in India. Infection. 1992 Jul-Aug. 20(4):189-91. [QxMD MEDLINE Link].

44. Ozgoztasi O, Baydar I. A randomized clinical trial of topical paromomycin versus oral ketoconazole for treating cutaneous leishmaniasis in Turkey. Int J Dermatol. 1997 Jan. 36(1):61-3. [QxMD MEDLINE Link].

45. Alrajhi AA, Ibrahim EA, De Vol EB, Khairat M, Faris RM, Maguire JH. Fluconazole for the treatment of cutaneous leishmaniasis caused by Leishmania major. N Engl J Med. 2002 Mar 21. 346(12):891-5. [QxMD MEDLINE Link].

46. Machado PR, Ampuero J, Guimarães LH, Villasboas L, Rocha AT, Schriefer A, et al. Miltefosine in the treatment of cutaneous leishmaniasis caused by Leishmania braziliensis in Brazil: a randomized and controlled trial. PLoS Negl Trop Dis. 2010 Dec 21. 4(12):e912. [QxMD MEDLINE Link]. [Full Text].

47. Soto J, Toledo JT. Oral miltefosine to treat new world cutaneous leishmaniasis. Lancet Infect Dis. 2007 Jan. 7(1):7. [QxMD MEDLINE Link].

48. Ben Salah A, Ben Massaoud N, Guedri E, et al. Topical paromomycin with or without gentamicin for cutaneous leishmaniasis. N Engl J Med. 2013. 368:524-32.

49. Keller DM. Novel noninvasive method for diagnosis of visceral leishmaniasis by rK39 testing of sputum samples. Medscape Medical News. February 7, 2013. Available at http://www.medscape.com/viewarticle/778974. Accessed: February 18, 2013.

50. El-On J, Livshin R, Even-Paz Z, Hamburger D, Weinrauch L. Topical treatment of cutaneous leishmaniasis. J Invest Dermatol. 1986 Aug. 87(2):284-8. [QxMD MEDLINE Link].

51. Braunwald E, Fauci AS, Hauser SL, et al. Leishmaniasis. 15th ed. Harrison's Manual of Medicine. 2001: McGraw-Hill;

52. Masmoudi A, Dammak A, Chaaben H, Maalej N, Akrout F, Turki H. Doxycycline for the treatment of cutaneous leishmaniasis. Dermatol Online J. 2008 Aug 15. 14(8):22. [QxMD MEDLINE Link].

53. Reithinger R, Mohsen M, Wahid M, Bismullah M, Quinnell RJ, Davies CR, et al. Efficacy of thermotherapy to treat cutaneous leishmaniasis caused by Leishmania tropica in Kabul, Afghanistan: a randomized, controlled trial. Clin Infect Dis. 2005 Apr 15. 40(8):1148-55. [QxMD MEDLINE Link].

54. Singh OP, Singh B, Chakravarty J, Sundar S. Current challenges in treatment options for visceral leishmaniasis in India: a public health perspective. Infect Dis Poverty. 2016 Mar 8. 5 (1):19. [QxMD MEDLINE Link].

55. Sindermann H, Engel KR, Fischer C, Bommer W; Miltefosine Compassionate Use Program. Oral miltefosine for leishmaniasis in immunocompromised patients: compassionate use in 39 patients with HIV infection. Clin Infect Dis. 2004 Nov 15. 39(10):1520-3. [QxMD MEDLINE Link].

56. Tiuman TS, Santos AO, Ueda-Nakamura T, Filho BP, Nakamura CV. Recent advances in leishmaniasis treatment. Int J Infect Dis. 2011 Aug. 15(8):e525-32. [QxMD MEDLINE Link].

57. Lemesre JL, Holzmuller P, Cavaleyra M, Gonçalves RB, Hottin G, Papierok G. Protection against experimental visceral leishmaniasis infection in dogs immunized with purified excreted secreted antigens of Leishmania infantum promastigotes. Vaccine. 2005 Apr 22. 23(22):2825-40. [QxMD MEDLINE Link].

58. Rubiano LC, Miranda MC, Muvdi Arenas S, Montero LM, Rodríguez-Barraquer I, Garcerant D, et al. Noninferiority of miltefosine versus meglumine antimoniate for cutaneous leishmaniasis in children. J Infect Dis. 2012 Feb 15. 205(4):684-92. [QxMD MEDLINE Link]. [Full Text].

59. Brooks M. FDA Clears Miltefosine (Impavido) for Leishmaniasis. Medscape Medical News. Mar 20 2014. [Full Text].

60. Alvar J, Cañavate C, Gutiérrez-Solar B, Jiménez M, Laguna F, López-Vélez R, et al. Leishmania and human immunodeficiency virus coinfection: the first 10 years. Clin Microbiol Rev. 1997 Apr. 10(2):298-319. [QxMD MEDLINE Link].

61. World Health Organization. Essential leishmaniasis maps: cutaneous leishmaniasis. Available at http://www.who.int/leishmaniasis/leishmaniasis_maps/en/index1.html. Accessed: April 10, 2014.

Craig G Stark, MD, FACP, FFTM, RCPS(Glasg), FISTM Telemedicine and Digital Health, CedarBridge Capital Partners

Craig G Stark, MD, FACP, FFTM, RCPS(Glasg), FISTM is a member of the following medical societies: American College of Physicians-American Society of Internal Medicine, International Society of Travel Medicine, Phi Beta Kappa, Royal College of Physicians and Surgeons of Glasgow, Society of US Army Flight Surgeons

Disclosure: Nothing to disclose.

Conjivaram Vidyashankar, MD, MRCP Specialty Doctor in Community Paediatrics, Royal Aberdeen Children's Hospital, Scotland

Conjivaram Vidyashankar, MD, MRCP is a member of the following medical societies: European Society for Paediatric Infectious Diseases, Indian Academy of Pediatrics, International AIDS Society, Royal College of Paediatrics and Child Health

Disclosure: Nothing to disclose.

Pranatharthi Haran Chandrasekar, MBBS, MD Professor, Chief of Infectious Disease, Department of Internal Medicine, Wayne State University School of Medicine

Pranatharthi Haran Chandrasekar, MBBS, MD is a member of the following medical societies: American College of Physicians, American Society for Microbiology, International Immunocompromised Host Society, Infectious Diseases Society of America

Disclosure: Nothing to disclose.

Ruchir Agrawal, MD Chief, Allergy and Immunology, Aurora Sheboygan Clinic

Ruchir Agrawal, MD, is a member of the following medical societies: American Academy of Allergy Asthma and Immunology, American Academy of Pediatrics, American College of Allergy, Asthma and Immunology, and American Medical Association

Disclosure: Nothing to disclose.

Pranatharthi Haran Chandrasekar, MBBS, MD Professor, Department of Internal Medicine, Director of Infectious Disease Fellowship, Harper Hospital, Wayne State University School of Medicine

Pranatharthi Haran Chandrasekar, MBBS, MD is a member of the following medical societies: American College of Physicians and Infectious Diseases Society of America

Disclosure: Nothing to disclose.

Dirk M Elston, MD Director, Ackerman Academy of Dermatopathology, New York

Dirk M Elston, MD is a member of the following medical societies: American Academy of Dermatology

Disclosure: Nothing to disclose.

John Halpern, DO, FACEP Clinical Assistant Professor, Department of Family Medicine, Nova Southeastern University College of Osteopathic Medicine; Medical Director, Health Career Institute; Medical Director Emergency Department, Palms West Hospital

John Halpern, DO, FACEP is a member of the following medical societies: American College of Emergency Physicians

Disclosure: Nothing to disclose.

Edmond A Hooker II, MD, DrPH, FAAEM Associate Professor, Department of Health Services Administration, Xavier University, Cincinnati, Ohio; Assistant Professor, Department of Emergency Medicine, University of Cincinnati College of Medicine

Edmond A Hooker II, MD, DrPH, FAAEM is a member of the following medical societies: American Academy of Emergency Medicine, American Public Health Association, Society for Academic Emergency Medicine, and Southern Medical Association

Disclosure: Nothing to disclose.

Renee Y Hsia, MD, MSc Clinical Instructor, Division of Emergency Medicine, University of California at San Francisco School of Medicine; Attending Physician, Department of Emergency Medicine, San Francisco General Hospital

Disclosure: Nothing to disclose.

Julie R Kenner, MD, PhD Private Practice, Kenner Dermatology Center

Julie R Kenner, MD, PhD is a member of the following medical societies: American Academy of Dermatology and American Society for Dermatologic Surgery

Disclosure: Nothing to disclose.

Thomas M Kerkering, MD Chief of Infectious Diseases, Virginia Tech Carilion School of Medicine

Thomas M Kerkering, MD is a member of the following medical societies: Alpha Omega Alpha, American College of Physicians, American Public Health Association, American Society for Microbiology, American Society of Tropical Medicine and Hygiene, Infectious Diseases Society of America, Medical Society of Virginia, and Wilderness Medical Society

Disclosure: Nothing to disclose.

Abdul-Ghani Kibbi, MD Professor and Chair, Department of Dermatology, American University of Beirut Medical Center, Lebanon

Disclosure: Nothing to disclose.

Jennifer J Lee MD, Assistant Professor, Division of Dermatology, Department of Medicine, Vanderbilt University Medical Center

Jennifer J Lee is a member of the following medical societies: American Academy of Dermatology

Disclosure: Nothing to disclose.

Lester F Libow, MD Dermatopathologist, South Texas Dermatopathology Laboratory

Lester F Libow, MD is a member of the following medical societies: American Academy of Dermatology, American Society of Dermatopathology, and Texas Medical Association

Disclosure: Nothing to disclose.

Gary J Noel, MD Professor, Department of Pediatrics, Weill Cornell Medical College; Attending Pediatrician, New York-Presbyterian Hospital

Gary J Noel, MD is a member of the following medical societies: Pediatric Infectious Diseases Society

Disclosure: Nothing to disclose.

William G Stebbins, MD Assistant Professor of Medicine, Division of Dermatology, Vanderbilt University

William G Stebbins, MD is a member of the following medical societies: American Academy of Dermatology, American Society for Dermatologic Surgery, and Dermatology Foundation

Disclosure: Nothing to disclose.

Russell W Steele, MD Head, Division of Pediatric Infectious Diseases, Ochsner Children's Health Center; Clinical Professor, Department of Pediatrics, Tulane University School of Medicine

Russell W Steele, MD is a member of the following medical societies: American Academy of Pediatrics, American Association of Immunologists, American Pediatric Society, American Society for Microbiology, Infectious Diseases Society of America, Louisiana State Medical Society, Pediatric Infectious Diseases Society, Society for Pediatric Research, and Southern Medical Association

Disclosure: Nothing to disclose.

Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Medscape Salary Employment

Jeter (Jay) Pritchard Taylor III, MD Compliance Officer, Attending Physician, Emergency Medicine Residency, Department of Emergency Medicine, Palmetto Health Richland, University of South Carolina School of Medicine; Medical Director, Department of Emergency Medicine, Palmetto Health Baptist

Jeter (Jay) Pritchard Taylor III, MD is a member of the following medical societies: American Academy of Emergency Medicine, American College of Emergency Physicians, American Medical Association, and Society for Academic Emergency Medicine

Disclosure: Nothing to disclose.

N Ewen Wang, MD Consulting Staff, Department of Surgery, Division of Emergency Medicine, Stanford University Hospital

Disclosure: Nothing to disclose.

Peter J Weina, MD, PhD Colonel, US Army; Deputy Commander/Deputy Director, Medical Director of the Leishmania Diagnostics Laboratory, Walter Reed Army Institute of Research

Peter J Weina, MD, PhD is a member of the following medical societies: American College of Physicians, American Society of Tropical Medicine and Hygiene, Association of Military Surgeons of the US, and International Society of Travel Medicine

Disclosure: Nothing to disclose.

Michael J Wells, MD Associate Professor, Department of Dermatology, Texas Tech University Health Sciences Center, Paul L Foster School of Medicine

Michael J Wells, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Dermatology, American Medical Association, and Texas Medical Association

Disclosure: Nothing to disclose.

Mary L Windle, PharmD Adjunct Associate Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Nothing to disclose.

Acknowledgments

The opinions or assertions contained herein are the private views of the authors and are not to be construed as official or as reflecting the views of the Department of the Army or the Department of Defense.

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