Interactive Atlas of Leishmaniasis in the Americas: Clinical Aspects and Differential Diagnosis

Abstract

In the Region of the Americas, the leishmaniases are a group of diseases caused by various species of Leishmania, which cause a set of clinical syndromes in infected humans that can involve the skin, mucosa, and visceral organs. The spectrum of clinical disease is varied and depends on the interaction of several factors related to the parasite, the vector, and the host. Cutaneous leishmaniasis is the form most frequently reported in the Region and nearly 90% of cases present single or multiple localized lesions. Other cutaneous clinical forms, such as disseminated and diffuse cutaneous leishmaniasis, are more difficult to treat and relapses are common. The mucosal form is serious because it can cause disfigurement and severe disability if not diagnosed and treated early on. Visceral leishmaniasis is the most severe form, as it can cause death in up to 90% of untreated people. In the Americas, clinical differences can be frequently found between endemic countries, mainly in the cutaneous form. Furthermore, many other diseases can be confused clinically with the different presentations of leishmaniasis and this is one of the greatest challenges for diagnosticians of the disease, who must also be aware of epidemiological reports and the patient’s clinical history. This Interactive Atlas of Leishmaniasis in the Americas: Clinical Aspects and Differential Diagnosis is a joint effort of the Pan American Health Organization, experts on this subject, and other collaborators, with support from the Federico Lleras Acosta University Hospital Dermatology Center of Colombia and the health ministries of the countries of the Region. This is an important and innovative publication that takes a practical approach to the subject, allowing professionals to interactively search for and study photographs and illustrations that reflect their daily work in the health services. The atlas discusses the main concepts and knowledge about leishmaniasis in the Americas, illustrating the clinical situation of these diseases in 10 endemic countries, through 1,029 photographs and illustrations that can be viewed on smartphones, tablets, and desktop or laptop computers. We believe the material will be valuable for all students and professionals at all levels of health care, including those in other continents, when treating patients infected in the Americas.