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: With increasing travel on the part of Singaporeans along less well-trodden paths to exotic destinations as well as the burgeoning traffic of migrant workers from less developed countries, doctors in Singapore will continue to see diseases such as leishmaniasis. We report the first case of culture-proven visceral leishmaniasis in Singapore, in a 30-year-old Bangladeshi worker who presented with pyrexia of unknown origin (PUO).