Pathophysiology:The Leishmaniases are diseases caused by protozoan parasites from more than 20 Leishmania species that are transmitted to humans by the bites of infected female phlebotomine sandflies. The disease can present in three main ways: cutaneous, mucocutaneous, or visceral leishmaniasis The cutaneous form presents with skin ulcers, while the mucocutaneous form presents with ulcers of the skin, mouth, and nose, and the visceral form starts with skin ulcers and then later presents with fever, low red blood cells, and enlarged spleen and liver.
Treatment:The treatment is determined by where the disease is acquired, the species of Leishmania, and the type of infection. For visceral leishmaniasis in India, South America, and the Mediterranean, liposomal amphotericin B is the recommended treatment and is often used as a single dose A number of topical treatments may be used for cutaneous leishmaniasis. Which treatments are effective depends on the strain, with topical paromomycin effective for L. major, L. tropica, L. mexicana, L. panamensis, and L. braziliensis.
Statistics: Despite its widespread distribution the countries of the Pacific, including Australia, have remained free of the disease. Contrary to what most Australians think Australian sandflies rarely, if ever, bite humans. Most bites are actually from species of midges, small robust insects with piercing and sucking mouthparts not known to be vectors of Leishmania. So it came as something of a shock to scientists when, in 2003, Leishmania was discovered in kangaroos in the Northern Territory of Australia. Even more surprising was the parasite appeared to be a new species not previously identified anywhere else in the world.