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212 Leishmaniasis
Shyam Sundar

	Figure 212-1  A macrophage with numerous intracellular amastigotes (2–4 μm) in a Giemsa-stained splenic smear from a patient with visceral leishmaniasis. Each amastigote contains a nucleus and a characteristic kinetoplast consisting of multiple copies of mitochondrial DNA. A few extracellular parasites are also visible.
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	Figure 212-2  Worldwide distribution of human leishmaniasis.
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	Figure 212-3  A patient with visceral leishmaniasis has a hugely enlarged spleen visible through the surface of the abdomen. Splenomegaly is the most important feature of visceral leishmaniasis.
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	Figure 212-4  Post–kala-azar dermal leishmaniasis in an Indian patient. Note nodules of varying size involving the entire face. The face is erythematous, and the surface of some of the large nodules is discolored.
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	Figure 212-5  Cutaneous leishmaniasis in a Bolivian child. There are multiple ulcers resulting from several sandfly bites. The edges of the ulcers are raised. (Courtesy of P. Desjeux.)
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	Figure 212-6  Mucosal leishmaniasis in a Brazilian patient. There is extensive inflammation around the nose and mouth, destruction of the nasal mucosa, ulceration of the upper lip and nose, and destruction of the nasal septum. (Courtesy of R. Dietz.)
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