Leishmaniasis–HIV coinfection: current challenges

Figures & data

Table 1 Leishmania species related to clinical manifestation of tegumentary leishmaniasis.

	Localized cutaneous leishmaniasis	Leishmaniasis recidiva cutis	Disseminated leishmaniasis	Diffuse cutaneous leishmaniasis	Mucocutaneous leishmaniasis
Tegumentary lesions	Round, well-delimited, painless ulcer with a central crust, sometimes hemorrhagic	Papule and vesicular lesions after clinical cure in or around the scar of an already healed lesion	Multiple pleomorphic lesions (10–300) often acneiform and papular, in two or more noncontiguous areas of the body surface	Nodular lesions that do not evolve into ulcerations, acting as an anergic pattern	Occurs years after the onset of TL. Destruction of oral–nasal and pharyngeal cavities that may evolve into disfiguring lesions. May start as a mild nasal inflammation and stuffiness, followed by ulcerations and perforations of the septum, extending to soft palate, pharynx, or larynx
Species	L. major, L. aethiopica, L. tropica, L. mexicana, L. amazonensis, L. (V.) braziliensis, L. (V.) guyanensis, L. (V.) shawi, L. (V.) lainsoni, and L. (V.) naiffi	L. aethiopica and L. (V.) braziliensis	L.(V.) braziliensis	L. mexicana and L. amazonensis in the Americas and L. aethiopica in Asia, Africa and Europe	L. (V.) braziliensis and L. (V.) guyanensis

Abbreviation: TL, tegumentary leishmaniasis.

Figure 1 Life cycle of Leishmania into the vertebrate and invertebrate host.

Note: Image modified from Centers for Disease Control and Prevention. Available from http://phil.cdc.gov/phil/home.asp.

Figure 2 Lesions of tegumentary leishmaniasis.

Note: (A) Typical cutaneous lesion- localized cutaneous leishmaniasis, (B) Unusual manifestation of cutaneous leishmaniasis, characterized by large cutaneous ulceration, (C) and (D) Mucocutaneous leishmaniasis.

Figure 3 Clinical manifestation of visceral leishmaniasis in HIV-infected patient, showing hepatomegaly and splenomegaly.