Leishmaniasis in infants and children

Leishmaniasis is a group of diverse diseases caused by hemoflagellate protozoa of the genus Leishmania. These infections are found in the tropical and subtropical world and are transmitted by sandflies. These organisms parasitize macrophages in visceral organs, mucosa, and skin. Three major clinical syndromes are recognized: visceral, cutaneous, and mucocutaneous leishmaniasis. In each of these disease entities, especially visceral leishmaniasis, children often are affected. Leishmaniasis has emerged as an AIDS-associated opportunistic infection in endemic areas, especially in the Mediterranean basin. The diagnosis is based on identification of organisms on biopsy or culture, but molecular and immunologic methods are becoming more accepted. Pentavalent antimony compounds have been the most reliable therapy for leishmaniasis for more than 50 years. However, in recent years other drugs have been found to be efficacious. Copyright (C) 2000 by W.B. Saunders Company.