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Harrison's Principles of Internal Medicine, 18e
| Part 8. Infectious Diseases > Section 18. Protozoal Infections > |
Chapter 212. Leishmaniasis
Sections: Leishmaniasis: Introduction, Further Readings.
Topics Discussed: leishmaniasis; parasitic diseases; parasitology.
Excerpt:"Encompassing a complex group of disorders, leishmaniasis is caused by unicellular eukaryotic obligatory intracellular protozoa of the genus Leishmania and primarily affects the host's reticuloendothelial system. Leishmania species produce widely varying clinical syndromes ranging from self-healing cutaneous ulcers to fatal visceral disease. These syndromes fall into three broad categories: visceral leishmaniasis (VL), cutaneous leishmaniasis (CL), and mucosal leishmaniasis (ML).The majority of individuals infected by L. donovani or L. infantum mount a successful immune response and control the infection, never developing symptomatic disease. Forty-eight hours after intradermal injection of killed promastigotes, these individuals exhibit delayed-type hypersensitivity (DTH) to leishmanial antigens in the leishmanin skin test (also called the Montenegro skin test). Results in mouse models indicate that the development of acquired resistance to leishmanial infection is controlled by the production of interleukin (IL) 12 by antigen-presenting cells and the subsequent secretion of interferon (IFN)  , tumor necrosis factor (TNF)  , and other..."
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