Leishmaniasis: the touch preparation as a rapid means of diagnosis

A 31-year-old man from Yemen presented with a 6-month history of a nonhealing ulcerated plaque on his right elbow. Initial evaluation included hematoxylin-and-eosin and Giemsa stains of a skin biopsy specimen. These preparations were interpreted as consistent with leishmaniasis, but no organisms were seen. A second biopsy specimen was obtained for culture on special media. A touch preparation demonstrated amastigotes, and cultures demonstrated leishmanial organisms at 2 weeks. The touch preparation as a rapid means of diagnosing leishmaniasis is discussed in detail, and a review of leishmanial disease and treatment is presented.