AMERICAN TERGUMENTARY LEISHMANIASIS: BIOLOGICAL CHARACTERISTICS, PATHOPHYSIOLOGY, DIAGNOSIS AND TREATMENT

Abstract

American Tegumentary Leishmaniasis (ATL) is a zoonosis of significant epidemiological relevance, caused by protozoa of the Leishmania genus and transmitted by phlebotomine sandflies. This study presents a narrative literature review aimed at analyzing diagnostic and therapeutic advances in ATL, incorporating biotechnological innovations and identifying gaps in clinical management. The databases PubMed, SciELO, and Medline were consulted, covering publications from 2014 to 2024. Polymerase chain reaction (PCR) has emerged as a sensitive and specific method for early diagnosis. In terms of treatment, drugs such as miltefosine and liposomal amphotericin B have shown greater clinical efficacy and lower toxicity compared to traditional pentavalent antimonials. Adjunct therapies, including immunomodulators and photodynamic therapy, are also being explored. However, the genetic variability of Leishmania and its genomic plasticity contribute to treatment resistance, posing challenges to effective disease control. The findings demonstrate promising advances, although genetic resistance remains a significant barrier to effective ATL management, underscoring the need for new therapeutic strategies based on a deeper understanding of the parasite’s genetics and biology.