South and Central America especially Brazil, Mexico and Colombia.
Skin and mucous membrane
The definitive host for the Leishmania Braziliensis is man and the reservoir hosts are the rodents and wild animals
1- Leishmania Braziliensis braziliensis
2- Leishmania Braziliensis guyanensis
3- Leishmania Braziliensis panamensis.
Female Lutzomyia is a genus of “sand flies” which is responsible for the transmission of leishmaniasis and other diseases like Carrion’s disease.
Only females suck blood, and they produce some hundreds of eggs, which are deposited in dark, humid places, like under stones and rotten leaves. After 2-3 months, they develop through 3 larval instars and pupate, then become adults, they usually move by short flights, and only bite parts of the body not covered by clothes.
1- the promastigotes enter the blood through the Female Lutzomyia
2- Macrophages phagocytoze the promastigotes
3- Progmastigotes converts into amastigotes
4- multiplying by simple division
In Female Lutzomyia:-
1- Female Lutzomyia ingest the infected cell with amastigotes
2- Amastigotes converts into promastigotes in the luzomyia
Symptoms and pathology:-
Leishmania braziliensis produces mucocutaneous leishmaniasis, characterized by lesions near mucosal membranes. The initial site if infection is a small red papule that ulcerates in a few weeks. The lesions are flat (no raised rim) and often oozing. Infections of the ear, nose and mouth area lead to degeneration of the cartilage and soft tissues, resulting in disfigurement. Spread is either direct or metastatic through lymphatic or blood The most serious form of the disease, called Espundia, can be fatal.
Miltefosine is showed high efficacy specifically against mucocutaneous cases caused by L.brasiliensis in the clinical trials in Colombia.