Anti-leishmanial Drug Discovery: Rising to the Challenges of a Highly Neglected Disease

Table 1

Predominant Clinical Manifestations, Characteristics, and Geographic Distribution of Leishmaniasis

Predominant Clinical Manifestation	Symptoms	Leishmania species	Predominant Geographic Distribution
Cutaneous	Skin lesions or ulcers that can self heal, with scar- ring and disfigurement. Lesions usually appear on exposed skin such as hands, face, or legs.	L. aethiopica (Old World) L. killicki^* (Old World) L. major (Old World) L. tropica^* (Old World) L. amazonensis (New World) L. garnhami (New World) L. mexicana (New World) L. pifanoi (New World) L. venezuelensis (New World)	Middle East, North and Sub- Saharan Africa, and South America
Muco-cutaneous	Initiates as skin lesions that metastasize to mucous membranes leading to the destruction of the oral cavity, larynx, and pharnyx. Tissue destruction elevates infection risk.	L. Vianna (V.) braziliensis^** (New World) L. V. colombiensis (New World) L. V. guyanensis (New World) L. V. lainsoni (New World) L. V. naiffi (New World) L. V. panamensis (New World) L. V. peruviana (New World) L. V. shawi (New World)	Central and South America
Visceral	Dissemination of parasites to internal organs. Characterized by fever, weight loss, hepatosplenomegaly, anemia and immunosuppression. Death results if untreated.	L. donovani (Old World) L. infantum^* (Old World) L. chagasi^* (New World)	Europe, East Africa, Central and South America, Central and Southeast Asia

↵* L. killiki might be a subspecies of L. tropica;
↵** Majority of M-CL results from L. braziliensis;
↵*** L. infantum and L. chagasi are the same species and L. donovani predominates in VL.