Cutaneous Leishmaniasis in a Recreational Cave Diver After Travel to México

Cutaneous Leishmaniasis due to Leishmania mexicana is a common cause of New World protozoal infections endemic to southern Mexico and now the United States (US). We present a case of a 72-year-old male who became infected with cutaneous L. mexicana while participating in numerous diving excursions in the flooded limestone caves, commonly referred to as cenotes, in the Yucatán Peninsula. This unique case of adventure tourism highlights cave diving in endemic regions of leishmaniasis as a possible new risk factor for the acquisition of this disease. We also discuss increasing autochthonous cases of cutaneous leishmaniasis and the different barriers to treatment that occur with this disease.