Leishmaniasis: Causes, Symptoms, and Treatment
Written by Sumiran Racherla, MD. Medically reviewed by Harsha Moole, MD, Internal Medicine. Last reviewed: October 23, 2026.
What kind of doctor treats Leishmaniasis?
An infectious disease doctor, a doctor who treats illnesses caused by germs and parasites, usually leads care for leishmaniasis. A dermatologist, a skin doctor, may help with skin sores. A direct primary care or concierge doctor can be a first stop for an evaluation and can refer you to a specialist when needed.
What is leishmaniasis?
Leishmaniasis is a parasitic disease caused by Leishmania parasites. They are spread by the bite of infected sand flies.
There are several forms. The most common form causes skin sores. Another form can cause sores in the nose, mouth, or throat. It can be life threatening. A third form, called visceral leishmaniasis, affects internal organs. It is less common, especially in the United States.
Symptoms
Some people have no symptoms.
People with the skin form have one or more skin sores. The sores usually appear within a few weeks or months of the bite. A sore may become a skin ulcer that heals very slowly.
Symptoms of the skin form depend on where the sores are. They may include:
- Breathing difficulty.
- Ulcers and wearing away (erosion) in the mouth, tongue, gums, lips, nose, and inner nose.
People with the visceral form may have fever, general illness, and anemia, which means low red blood cells. Other symptoms may include:
- Fever that lasts for weeks and may come and go in cycles.
- Weight loss.
Causes and who gets it
The main way people get infected is through the bite of an infected female sand fly.
Anyone who lives in or travels to an area where the parasites occur and is bitten by an infected sand fly is at risk. The disease occurs in parts of approximately 90 countries.
Most cases found in the United States are in people who were infected while traveling or living in other countries.
Some types of the parasite can also spread through shared needles or blood transfusions.
How doctors diagnose it
Your provider will ask whether you remember sand fly bites or have been in an area where leishmaniasis is common. The exam may find an enlarged spleen, liver, or lymph nodes.
Doctors test tissue samples from skin sores for the skin form, or from bone marrow for the visceral form. Blood tests can help for the visceral form.
Treatment
Treatment decisions should be tailored to each person, with advice from experts.
In general, doctors treat all visceral and mucosal cases that cause symptoms. Not all skin cases need treatment. Some skin sores might heal on their own, depending on the type of parasite.
Medicines that contain antimony, a type of metal, have been the traditional main treatment since the 1940s. In the United States, they are not FDA approved and are not commercially available.
For the visceral form, liposomal amphotericin B is FDA-approved and is generally the treatment of choice for patients in the United States. In 2014, the FDA approved miltefosine, a medicine taken by mouth, for the skin form in adults and teens who are not pregnant or breastfeeding. The approval covers skin infections caused by only three types of the parasite. Miltefosine must not be used in pregnancy.
Care for the visceral form includes supportive care, such as treating malnutrition, anemia or bleeding, and other infections. In people with weak immune systems, such as from HIV or malnutrition, the visceral form can be hard to treat.
Cure rates are high with the proper medicine, mostly when treatment is started before it affects the immune system.
There are no vaccines or drugs to prevent leishmaniasis. The best way to prevent infection is to protect yourself from sand fly bites. You can help lower your risk by:
- Putting fine mesh netting around the bed, in areas where the disease occurs.
- Screening windows.
- Wearing insect repellent.
- Wearing protective clothing.
Even if you already had leishmaniasis, it is possible to get it again.
When to see a doctor
See your healthcare provider if you think you have leishmaniasis. Contact your provider if you have symptoms after visiting an area where the disease is known to occur.
Do not wait, because the mucosal form can be life threatening if it affects the throat. Severe untreated visceral cases are typically deadly.
Call 911 or go to the emergency room if you have severe trouble breathing, bleeding that will not stop, or fainting.
How a direct primary care or concierge doctor fits in
A direct primary care doctor charges a flat monthly fee instead of billing insurance, while a concierge doctor usually charges more and often works alongside insurance. A direct primary care doctor can review your travel history and symptoms and order first tests. They can also help you reach an infectious disease specialist and keep up with follow-up care.
Common questions
Is leishmaniasis spread from person to person?
Not usually, because the main way people get infected is through the bite of an infected female sand fly. Some types can also spread through shared needles or blood transfusions. There have also been reports of a mother passing the infection to her baby during pregnancy or at birth.
Can leishmaniasis be cured?
Yes, cure rates are high with the proper medicine, mostly when treatment is started before it affects the immune system.
Can you get leishmaniasis in the United States?
Yes. Most cases found in the United States are in people who were infected while traveling or living in other countries. Occasionally, people have had skin leishmaniasis acquired in the US, especially in Texas.
Does leishmaniasis always cause symptoms?
No, people may or may not have symptoms.
Sources
Medical Disclaimer
This content is for general educational and informational purposes only and is not medical advice. It is not a substitute for professional medical advice, diagnosis, or treatment, and reading it does not create a doctor-patient relationship. Always seek the advice of your physician or another qualified health provider with any questions about a medical condition, and never disregard or delay seeking professional advice because of something you read here. If you think you may have a medical emergency, call 911 (or your local emergency number) immediately.
