How I Approach Leishmaniasis: Diagnosis and Treatment in the United States

Authors

Tara E Ness
Rachel Martin-Blais
Jill E Weatherhead

Publication Date

12-5-2022

Journal

Journal of the Pediatric Infectious Diseases Society

DOI

10.1093/jpids/piac087

PMID

36043874

PMCID

PMC9720369

PubMedCentral® Posted Date

8-31-2022

PubMedCentral® Full Text Version

Post-print

Published Open-Access

yes

Keywords

Child, Humans, United States, Leishmaniasis, Leishmania, Antiprotozoal Agents, Skin, Leishmaniasis, Cutaneous, : leishmaniasis, neglected tropical disease, parasites, tropical medicine

Abstract

Leishmaniasis is a vector-borne disease caused by over 20 species of obligate intracellular protozoa belonging to the genus Leishmania. Leishmaniasis has a global distribution, including in the United States, and can cause a spectrum of clinical syndromes, including cutaneous, mucosal, and visceral diseases depending on host factors and the infecting Leishmania spp. Accurate diagnosis, including Leishmania species identification, is an important step to guide the most appropriate therapeutic intervention. Antileishmanial therapy is dependent on the Leishmania spp. identified, the clinical syndrome, and the child's immune system. However, many treatment regimens for children have been extrapolated from adult clinical trials, which may lead to underdosing and subsequent poor outcomes in infected children. Additional research is urgently needed to help guide therapy for children and determine appropriate antileishmanial agents, doses, and treatment courses for children with leishmaniasis.