Clinical presentations of Leishmania braziliensis braziliensis

Leishmania braziliensis braziliensis (Lbb) is probably the most serious, leishmanial infection of the New World. Although epidemiological information is incomplete, its distribution is believed to extend from Belize in Central America to northern Argentina, involving all countries east of the Andes. Lbb causes a variety of clinical lesions and is one of the most difficult forms of leishmaniasis to treat. We still do not know how many patients suffer from mucosal disease requiring treatment. In this review of 10 years field experience in an endemic area of Brazil, Philip Marsden shows that parasitologists have much to contribute, especially in improving diagnostic methods, developing better animal models, and providing new drugs suitable for routine treatment on a large-scale.