Leishmania, endemic in nearly half the world’s countries, continues to pose significant diagnostic challenges. Our systematic review sought to analyse problems in diagnosis especially in low- to middle-income countries. The average time from symptom onset to diagnosis was 4.5 years. While microscopic detection often failed, polymerase chain reaction showed high sensitivity. Clinical presentations varied significantly, highlighting the complexity of diagnosing leishmaniasis, especially in patients with prolonged disease in non-endemic areas.
RodriguezABGiardinJMRMartinezJG, et al.Diagnostic model of visceral leishmaniasis based on bone marrow findings. Study of patients with clinical suspicion in which the parasite is not observed. Eur J Intern Med2019; 69: 42–49.
GagnierJJKienleGAltmanDG, et al.The CARE guidelines: consensus-based clinical case reporting guideline development. J Med Case Rep2013; 7: 1–6.
6.
SikorskaKGesingMOlszańskiR, et al.Misdiagnosis and inappropriate treatment of cutaneous leishmaniasis: a case report. Trop Dis Travel Med Vaccines2022; 8: 1–5.
7.
Di AltobrandoAMiscialiCRaoneB, et al.Case report: cutaneous leishmaniasis misdiagnosed as pyoderma gangrenosum. Am J Trop Med Hyg2021; 104: 640.
8.
VanlierCMarotLLaranagaE, et al.A case report of cutaneous leishmaniasis: a misleading clinical presentation. Infection2021; 49: 177–180.
9.
BastolaAShresthaMLamsalM, et al.A case of high altitude cutaneous leishmaniasis in a non-endemic region in Nepal. Parasitol Int2020; 74: 101991.
10.
GehlhausenJSibindiCKoCJ, et al.A rare case of lupoid leishmaniasis defying diagnosis for a decade. J Cutan Pathol2020; 47: 1054–1057.
11.
Al-DwibeHAmroAGashoutA, et al.A pyoderma gangrenous-like cutaneous leishmaniasis in a Libyan woman with rheumatoid arthritis: a case report. BMC Res Notes2018; 11: 1–4.
12.
GanjaeiKGLawtonKGaurS. Cutaneous leishmaniasis in an American adolescent returning from Israel. J Pediatric Infect Dis Soc2018; 7: e178–e181.
CalvopinaMAguirreCCevallosW, et al.Case report: coinfection of Leishmania guyanensis and human immunodeficiency virus–acquired immune deficiency syndrome: report of a case of disseminated cutaneous leishmaniasis in Ecuador. Am J Trop Med Hyg2017; 96: 1151.
15.
BaileyMSLangmanG. Misdiagnosis of cutaneous leishmaniasis and recurrence after surgical excision. BMJ Mil Heal2014; 160: 314–316.
16.
El HassanAMKhalilEAGElaminWM, et al.Misdiagnosis and mistreatment of post-kala-azar dermal leishmaniasis. Case Rep Med2013; 2013: 351579.
17.
MoravvejHBarzegarMNasiriS, et al. Cutaneous leishmaniasis with unusual clinical and histological presentation: report of four cases. Acta Med Iran2013; 51: 274–278.
18.
CarotenutoAAlbersGDHankinsR, et al.Clinical diagnosis and management of mucosal leishmaniasis in the context of a global pandemic: a case report. Cureus2022; 14: e30586.
19.
Crovetto-MartínezRAguirre-UrizarJMOrte-AldeaC, et al.Mucocutaneous leishmaniasis must be included in the differential diagnosis of midline destructive disease: two case reports. Oral Surg Oral Med Oral Pathol Oral Radiol2015; 119: e20–e26.
20.
TangCHeSWangN, et al.A case report and literature review: diagnosis and treatment of human immunodeficiency virus coinfected with visceral leishmania by metagenomic next-generation sequencing in China. Ann Transl Med2022; 10: 97.
21.
JaitehMBÇalık BaşaranNÖzışıkL, et al.Visceral leishmaniasis in a patient presenting with fever of unknown origin: a case report from a low-endemic region of Turkey. Turkiye Parazitol Derg2019; 43: 210–212.
22.
SayyahfarSAnsariSMohebaliM, et al.Visceral leishmaniasis without fever in an 11-month-old infant: a rare clinical feature of kala-azar. Korean J Parasitol2014; 52: 189.
23.
TopnoRKRabi DasVNKumarM, et al.Advanced case of PKDL due to delayed treatment: a rare case report. PLoS Negl Trop Dis2020; 14: e0008052.
24.
TrindadeMABSilvaLdCBrazLMA, et al.Post-kala-azar dermal leishmaniasis and leprosy: case report and literature review. BMC Infect Dis2015; 15: 1–8.
25.
ShiS-LZhaoHZhouB-J, et al.Diagnostic value of bone marrow cell morphology in visceral leishmaniasis-associated hemophagocytic syndrome: two case reports. World J Clin Cases2022; 10: 5463.
26.
NeychevaSOparanovBKamburovaA, et al.Hemophagocytic lymphohistiocytosis triggered by leishmaniasis: a case report and literature review. Am J Case Rep2021; 22: e933012.
27.
KhalilICollisonMEl BcheraouiC, et al.Maternal mortality and morbidity burden in the eastern Mediterranean region: findings from the global burden of disease 2015 study. Int J Public Health2018; 63: 47–61.
28.
KirosYKRegassaBF. The role of rk39 serologic test in the diagnosis of visceral leishmaniasis in a Tertiary Hospital, northern Ethiopia. BMC Res Notes2017; 10: 1–5.
29.
TorpianoPPaceD. Leishmaniasis: diagnostic issues in Europe. Expert Rev Anti Infect Ther2015; 13: 1123–1138.
30.
FernandoSDSiriwardanaHGuneratneK, et al.Some sociological aspects of cutaneous leishmaniasis in patients attending a tertiary referral centre in Colombo, Sri Lanka. Int Health2010; 2: 69–74.
31.
MannSFrascaKScherrerS, et al.A review of leishmaniasis: current knowledge and future directions. Curr Trop Med Reports2021; 8: 121–132.
32.
ThakurSJoshiJKaurS. Leishmaniasis diagnosis: an update on the use of parasitological, immunological and molecular methods. J Parasit Dis2020; 44: 253–272.
33.
MohammadiMABamorovatMHarandiMF, et al.Comparison of three PCR-based methods for simplicity and cost effectiveness identification of cutaneous leishmaniasis due to Leishmania tropica. Iran J Parasitol2017; 12: 215.
34.
CharguiNBastienPKallelK, et al.Usefulness of PCR in the diagnosis of cutaneous leishmaniasis in Tunisia. Trans R Soc Trop Med Hyg2005; 99: 762–768.
35.
SrivastavaPDayamaAMehrotraS, et al.Diagnosis of visceral leishmaniasis. Trans R Soc Trop Med Hyg2011; 105: 1–6.
36.
de VriesHJCReedijkSHSchalligHDFH. Cutaneous leishmaniasis: recent developments in diagnosis and management. Am J Clin Dermatol2015; 16: 99–109.
37.
KumarAPandeySCSamantM. A spotlight on the diagnostic methods of a fatal disease visceral leishmaniasis. Parasite Immunol2020; 42: e12727.
38.
MohebaliMKeshavarzHShirmohammadS, et al.The diagnostic accuracy of direct agglutination test for serodiagnosis of human visceral leishmaniasis: a systematic review with meta-analysis. BMC Infect Dis2020; 20: 1–12.
39.
SarkariBRezaeiZMohebaliM. Immunodiagnosis of visceral leishmaniasis: current status and challenges: a review article. Iran J Parasitol2018; 13: 331–341.
40.
KuhlsKAlamMZCupolilloE, et al.Comparative microsatellite typing of new world Leishmania infantum reveals low heterogeneity among populations and its recent old world origin. PLoS Negl Trop Dis2011; 5: e1155.
Supplementary Material
Please find the following supplemental material available below.
For Open Access articles published under a Creative Commons License, all supplemental material carries the same license as the article it is associated with.
For non-Open Access articles published, all supplemental material carries a non-exclusive license, and permission requests for re-use of supplemental material or any part of supplemental material shall be sent directly to the copyright owner as specified in the copyright notice associated with the article.
