SYNOPSIS OF PATHOLOGY


Eighth edition

W. A. D. Anderson Thomas M. Scotti




ISBN 0-8016-0229-7


The C. V. Mosby Company
St. Louis 1972




9. Mycotic, protozoan, and helminthic infections
Leishmaniasis........................... 263,264



Leishmaniasis. Leishmaniasis is a tropical condition caused by
protozoan parasites with a complex life cycle. Transmission is by the
Phlebotomus fly (sandfly). The three main types of Leishmania
(donovani, tropica, and brasiliensis) are morphologically
indistinguishable.

Leishmania donovani produces the disease kala-azar (visceral
leishinaniasis), prevalent in India and parts of China but also
occurring in the Mediterranean region. The organism can be seen in
phagocytic cells of the reticuloendothelial system. The intracellular
parasites in tissue sections resemble Histoplasma but can be
differentiated by the presence of the kinetoplast. The spleen is
greatly enlarged.

Leishmania tropica produces the oriental sore (cutaneous
leishmaniasis), a chronic granulomatous ulcer, prevalent in the
Mediterranean region and Central and South America.

Leishmania brasiliensis (American leishmaniasis; mucocutaneous
leishmaniasis) results in chronic granulomatous ulcers similar to the
oriental sore. There is a distinct tendency to involvement of the
skin and mucosa of the mouth, nose, and pharynx. The ear is also
commonly involved, especially among chicle workers of Yucatan
(Chiclero ulcer) . It occurs in Central and South America.