From the Guidelines
Leishmania infections can cause a range of symptoms, including skin sores, fever, weight loss, and destructive lesions, and require prompt treatment to prevent mortality and morbidity. The symptoms of Leishmania infections vary depending on the type of infection, with cutaneous leishmaniasis typically presenting as painless skin lesions, visceral leishmaniasis causing severe symptoms such as fever and weight loss, and mucocutaneous leishmaniasis affecting mucous membranes and causing destructive lesions 1.
Key Symptoms
- Cutaneous leishmaniasis: skin sores that start as bumps and grow into ulcers with raised edges at the site of the sand fly bite
- Visceral leishmaniasis (kala-azar): fever, weight loss, enlarged spleen and liver, anemia, and darkening of the skin
- Mucocutaneous leishmaniasis: destructive lesions in the nose, mouth, and throat tissues
Diagnosis and Treatment
Diagnosis requires laboratory confirmation through tissue samples or blood tests, and treatment varies by type but often includes medications like sodium stibogluconate, amphotericin B, miltefosine, or paromomycin for 20-28 days, as recommended by the Infectious Diseases Society of America (IDSA) and the American Society of Tropical Medicine and Hygiene (ASTMH) 1.
Importance of Early Treatment
Early treatment is essential to prevent complications, especially for visceral leishmaniasis, which can be fatal if untreated, and to improve quality of life for patients with cutaneous and mucocutaneous leishmaniasis 1.
From the FDA Drug Label
Table 2: Treatment Emergent Adverse Reactions Occurring in ≥2% of Visceral Leishmaniasis Patients Receiving IMPAVIDO Table 3: Adverse Reactions Occurring in ≥2% of IMPAVIDO-Treated Patients ≥12 Years of Age with Cutaneous Leishmaniasis in the Placebo-Controlled Trial Table 4: Adverse Reactions Occurring in ≥2% of IMPAVIDO-Treated Patients ≥ 12 Years of Age with Cutaneous Leishmaniasis in Two Comparative Trials
The symptoms of Leishmania are not directly listed in the provided drug label. However, based on the adverse reactions reported in the clinical trials for visceral and cutaneous leishmaniasis, the following symptoms can be inferred:
- Gastrointestinal symptoms:
- Diarrhea
- Vomiting
- Abdominal pain
- Nausea
- General symptoms:
- Asthenia
- Malaise
- Pyrexia
- Nervous system symptoms:
- Dizziness
- Headache
- Somnolence
- Skin and subcutaneous tissue symptoms:
- Pruritus
- Rash
- Urticaria
- Infections and infestations:
- Lymphangitis 2
From the Research
Leishmania Symptoms
- The genus Leishmania includes a number of protozoan parasites that cause a wide range of infections named leishmaniasis, which may appear in three clinical forms: cutaneous (CL), visceral, and mucocutaneous (MCL) 3.
- The prevalent signs of CL are nonhealing ulcers on exposed skin, but infected patients may have other dermatologic symptoms 3.
- Visceral leishmaniasis (VL) is a disseminated and potentially fatal form of leishmaniasis, caused by the Leishmania donovani complex, which includes L. chagasi and L. infantum 4.
- The symptoms of VL are not explicitly stated in the provided studies, but it is mentioned that untreated or poorly treated VL infection has a high mortality rate 5.
Clinical Forms of Leishmaniasis
- Cutaneous leishmaniasis (CL) can present in different forms, including diffuse CL and post-kala-azar dermal leishmaniasis 3.
- Mucocutaneous leishmaniasis (MCL) is another clinical form of the disease, but its symptoms are not described in the provided studies.
- Visceral leishmaniasis (VL) is a severe form of the disease that can be fatal if left untreated or poorly treated 4, 5.
Treatment Options
- The treatment options for leishmaniasis are limited, and the choice of treatment depends on the clinical form of the disease and the region where it is prevalent 3, 4, 5.
- Amphotericin B is an effective treatment for some forms of leishmaniasis, including VL and CL 3, 4, 6, 7.
- Liposomal amphotericin B is a more widely accepted treatment option than conventional amphotericin B, due to its lower toxicity and faster treatment effect 3, 7.