Abstract
Visceral leishmaniasis (VL) is caused by protozoa of the genus Leishmania, of the species Leismania (Leishmania) donovani and Leishmania (Leishmania) infantum, which occur in different geographic regions and are related to the diversity of clinical manifestations and therapeutic response. Notably, VL occurring mainly in India, Sudan, South Sudan, Bangladesh and Ethiopia is caused by L. donovani, while in the Americas and in some regions of Africa and Europe is caused by L. infantum. Visceral leishmaniasis caused by L. donovani has a clinical spectrum ranging from visceral involvement to cutaneous lesion that occurs after a VL episode, which is post-kala-azar-dermal-leishmaniasis (PKDL), which is not very frequent in the VL caused by L. infantum. In addition, the therapeutic response is divergent among these species, since in VL caused by L. donovani there is poor response to pentavalent antimony, setting a high resistance pattern, whereas in VL caused by L. infantum this information is not very clear. In this article, we discuss the clinical diversity and therapeutic response of VL caused mainly by L. infantum, which is occurring in the Americas.
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