Trypanosomatidae: Leishmania Species, Trypanosoma cruzi (Chagas Disease), and Associated Complications

Abstract

This chapter explains the postinfectious sequelae and long-term consequences of leishmaniasis and Chagas disease. A section discusses the long-term consequences and sequelae of leishmaniasis, with special emphasis on the long-term evolution of visceral leishmaniasis (VL) of immunosuppressed patients, post-kala-azar dermal leishmaniasis, the complications and scars resulting from localized CL (LCL), some particularly long-lasting forms of CL, and mucosal involvement of mucocutaneous leishmaniasis (MCL) and their disfiguring involvement and further sequelae. Treatment of all the leishmaniases remains difficult, due to the multiplicity of the existing Leishmania species and their variable susceptibility to the available drugs, which are old, toxic, and expensive products. Chagas disease is an infectious disease resulting from the parasitism of humans by Trypanosoma cruzi, a parasite of wild and domestic mammals, transmitted by blood-sucking triatomine bugs. The major causes of morbidity and mortality at the chronic stage are cardiac involvement, referred as chronic Chagas heart disease, and the “mega”-syndromes of the gastrointestinal tract. The major indications of the two specific trypanocidal drugs are in the acute phase of Chagas disease when diagnosed, congenital infection and prevention of accidental laboratory infections.