Sections View Full Chapter Figures Tables Videos Annotate Full Chapter Figures Tables Videos Supplementary Content + Download Section PDF Listen ++ For further information, see CMDT Part 35-03: Leishmaniasis + Key Features Download Section PDF Listen +++ ++ Destructive nasopharyngeal lesions Amastigotes in macrophages in aspirates, touch preparations, or biopsies Positive culture, serologic tests, PCR, or skin test Occurs in lowland forest areas of the Americas Caused by Leishmania braziliensis, Leishmania panamensis, and Leishmania peruviana + Clinical Findings Download Section PDF Listen +++ ++ Mucosal lesions develop usually months to years after resolution of a cutaneous lesion Nasal congestion is followed by ulceration of the nasal mucosa and septum Mouth, lips, palate, pharynx, and larynx become involved as infection progresses Extensive destruction can occur Secondary bacterial infection is common + Diagnosis Download Section PDF Listen +++ ++ Diagnosis is established by detecting amastigotes in scrapings, biopsy preparations, or aspirated tissue fluid, but organisms may be rare Cultures from these samples may grow organisms Serologic studies are often negative Leishmanin skin test is usually positive + Treatment Download Section PDF Listen +++ ++ Treat all cutaneous infections from regions where parasites include those that cause mucocutaneous disease to help prevent disease progression Treatment with antimonials is disappointing, with responses in only about 60% in Brazil See Leishmaniasis, Visceral (Kala Azar), but the drugs listed there have not been well studied for this indication