Leishmania braziliensis, Leishmania mexicana - Clinical manifestations, Epidemiology, Reservoir, Source, Transmission

Clinical manifestations of Leishmania braziliensis, Leishmania mexicana

Leishmania braziliensis Complex

Leishmania braziliensis causes the following clinical syndromes

Espundia

• espundia most severe and destructive form than the oriental sore

• mucocutaneous lesions are chronic, resistant to treatment

• single or multiple ulcers are present in the lower extremities

• the ulcers might not heal completely or spontaneously

• if metastasis occurs, lesions may appear in the mouth, nasopharynx even months to years after the occurrence of the primary lesion

• the perforation and severe destruction of the nasal septum through the soft palate or skin of the nose may result in the collapse of the nose, the condition termed tapir nose

• in advanced cases of espundia, soft tissues such as the upper lip, tongue, and buccal, pharyngeal, and laryngeal mucosa may occur

• other symptoms include fever, anemia, and weight loss

• death may occur due to secondary infections, pneumonia, or respiratory obstruction

Pian bois

• pain bois is also known as forest yawns

• caused by Leishmania braziliensis guyanensis

• single or multiple ulcers, which are dry, painless, and persistent appear all over the body

Uta

• uta is caused by Leishmania braziliensis peruviana

• ulcers, ranging from one to several in number, may be present on the face

• the nasopharynx is not affected

• lesions heal spontaneously within 3 months to a year

Non-healing ulcerate

• non-healing ulcerate caused by Leishmania braziliensis panamensis

• a single non-healing ulcer is present

• lymph nodes are present

Leishmania mexicana Complex

Leishmania mexicana causes the following clinical syndromes

Chiclero ulcerate

• chiclero ulcerate is also known as bay sore

• caused by Leishmania mexicana mexicana

• ulcers appear on the hand and head and are persistent for years

• although these ulcers heal spontaneously, they can entirely destroy the pinna of the ear

Indolent nodular lesion

• indolent nodular lesion is caused by Leishmania mexicana venezuelensis

Cutaneous single sore type

• cutaneous single sore type is caused by Leishmania mexicana amazonensis

• can cause diffuse cutaneous leishmaniasis

Diffuse cutaneous leishmaniasis

• usually, diffuse cutaneous leishmaniasis condition arises in hosts with poor immune response and is allergic

• the disease begins as a localized papule, lacks ulceration, and satellite lesions may appear around the papule in the skin

• the amastigotes can metastasize to the face and other extremities

• as this is a chronic infection, the syndromes may last 20 or more years

• the Leishmania skin test is negative in these cases

Epidemiology of Leishmania braziliensis, Leishmania mexicana

Epidemiological studies have confirmed that the new world cutaneous and mucocutaneous leishmaniasis are endemic to South and Central America- mostly in Bolivia, Brazil, and other Latin American countries.

Reservoir, Source of Leishmania braziliensis, Leishmania mexicana

Except for the condition uta, New World cutaneous and mucocutaneous leishmaniasis are zoonotic in nature. Mammals such as dogs, sloths, anteaters, and rats are reservoirs, sources of Leishmania braziliensis Complex and Leishmania mexicana Complex.

Transmission of Leishmania braziliensis, Leishmania mexicana

Transmission of mucocutaneous and cutaneous leishmaniasis, caused by Leishmania braziliensis, Leishmania Mexicana, occurs mostly by the bite of the sandfly vector. The infection is seen most commonly in individuals working at the edge of the forests and in rural areas.

They are less frequently transmitted by ticks, direct man-to-man transmission, and auto-infection.