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Diagnosis

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The Leishmaniases: Old Neglected Tropical Diseases

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Abstract

Diagnosis of leishmaniasis is an arduous topic that reflects the complexity of a heterogeneous disease. The clinical spectrum of leishmaniasis and its major syndromes (visceral, cutaneous, and mucocutaneous) depends on the parasite involved, the immune status of the host, and immune-inflammatory responses. All these issues can affect the diagnostic approach. Moreover, since clinical features of leishmaniasis mimic several other common or co-endemic diseases, accurate microbiologic diagnosis is crucial. Up to now the diagnosis of human leishmaniases includes the concurrent elements of clinic, epidemiology, and diagnostics. Here we critically review current laboratory approaches for leishmaniasis diagnosis, primarily focusing on their efficiency, quality, constraints, and cost. In fact being leishmaniasis one of the world’s most neglected disease, its diagnosis remains a great challenge, especially in endemic and poor regions. Simple diagnostic tools are necessary for field use. Methods are distinguished in parasitological, molecular, and immunological assays. Their efficiency was discussed in terms of single pathological entity and specifically as visceral, cutaneous, and mucocutaneous diseases. Particular attention is furthermore addressed to post-kala-azar dermal leishmaniasis, a dermal disease observed in apparently recovered visceral leishmaniasis patients, and immunosuppressive diseases, as Leishmania-HIV coinfections and non-HIV-related immunosuppressive diseases.

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Authors and Affiliations

  1. Vector-Borne Diseases, Department of Infectious Diseases, Istituto Superiore di Sanità, Rome, Italy

    Marina Gramiccia & Trentina Di Muccio

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  1. Marina Gramiccia
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  2. Trentina Di Muccio
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Correspondence to Marina Gramiccia .

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  1. Department of Translational Research, University di Pisa, Pisa, Italy

    Fabrizio Bruschi

  2. Department of Infectious Diseases, Istituto Superiore di Sanità, Roma, Italy

    Luigi Gradoni

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Gramiccia, M., Di Muccio, T. (2018). Diagnosis. In: Bruschi, F., Gradoni, L. (eds) The Leishmaniases: Old Neglected Tropical Diseases. Springer, Cham. https://doi.org/10.1007/978-3-319-72386-0_7

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