TABLE 2.

Disease spectra observed for humans infected with various trypanosomatids

Clinical syndrome or disease spectrum	Species	Distribution	Vector genus	Description
Visceral leishmaniasis	Leishmania donovani	Old World; parts of central Asia and East Africa	Phlebotomus	These Leishmania species may cause other syndromes (such as CL) in IC patients [see “Leishmania and HIV. (i) Atypical clinical features”]
	Leishmania infantuma	Old World; Mediterranean basin, Central Asia, Middle East, China	Phlebotomus
	Leishmania chagasia	New World; parts of Central and South America	Lutzomyia
	Leishmania tropica	Old World; Mediterranean basin, Middle East, Southwest Asia	Phlebotomus
Cutaneous leishmaniasis	Leishmania tropica	Old World; Mediterranean basin, Middle East, Southwest Asia	Phlebotomus	These Leishmania species may cause other syndromes (such as VL) in IC patients [see “Leishmania and HIV. (i) Atypical clinical features”]
	Leishmania major	Old World; Middle East, Southwest Asia, sub-Saharan Africa
	Leishmania aethiopica	Old World; Ethiopia, Kenya
	Leishmania killicki	North Africa
	Leishmania mexicana	New World; parts of Central America, South America, and the Southern regions of the United States	Lutzomyia
	Leishmania amazonensis
	Leishmania venezuelensis
	Leishmania braziliensis
	Leishmania panamensis
	Leishmania guyanensis
	Leishmania peruviana
	Leishmania lainsoni
	Leishmania colombiensis
	Leishmania pifanoi
	Leishmania garnhami
Mucocutaneous leishmaniasis	Leishmania panamensis	Parts of Central and South America	Lutzomyia	These Leishmania species may cause other syndromes (such as VL) in IC patients [see “Leishmania and HIV. (i) Atypical clinical features”]
	Leishmania braziliensis
	Leishmania braziliensis
	Leishmania guyanensis
Chagas' disease	Trypanosoma cruzi	Parts of Central and South America and South/Southwestern United States	Triatoma	In ICT patients, Chagas' disease is often associated with cardiopathies; in IC patients, Chagas' disease can also include CNS manifestations [see “Chagas' disease. (iv) Chagas' disease and HIV”]
African sleeping sickness (“nagana” in animals)	Trypanosoma brucei rhodesiense	Sub-Saharan Africa; Central and West Africa	Glossina	There is no evidence to indicate that the clinical course of sleeping sickness is worsened in IC patients
	Trypanosoma brucei gambiense
Sleeping sickness-like syndrome (“nagana” in animals)	Trypanosoma congolense	Sub-Saharan Africa	Glossina	The disease-causing potential of T. congolense is not certain, as the patient in this single report was also infected with a T. brucei species
Fever, chills, and sensory impairments (“surra” in animals)	Trypanosoma brucei evansi	Southeast Asia, Africa, and South America	Any hematophagous fly species and, in South America, vampire bats	T. b. evansi relies on mechanical transmission between hosts; therefore, any hematophagous insect or animal is a potential vector; in this single case report, the patient also experienced behavioral changes; the infection was partly attributed to a dysfunctional human trypanolytic factor
Transient fever (“nagana” in animals)	Trypanosoma brucei brucei	Sub-Saharan Africa	Glossina	In this case, T. b. brucei caused transient, self-limiting infection characterized by fever and severe dyspnea; only a single reported case; human infections with T. b. brucei are controversial
Fever, anemia, anorexia, and sometimes edema	Trypanosoma(Herpetosoma)lewisi	Malaysia, Africa, and India	Several species of flea	Trypanosoma lewisi infection is usually restricted to rodents; children seem to be more susceptible to T. lewisi infection than adults
Cutaneous leishmaniasis-like disease	Unnamed, highly divergent member of the genus Leishmania	Martinique	Vector unknown or nonexistent	Only 2 reported cases; this organism caused a small cutaneous, ulcerative lesion on the eyebrow of an ICT patient; for an HIV-infected patient, diffuse, cutaneous, nonulcerative lesions were reported
Visceral leishmaniasis-like syndrome	Undefined lower trypanosomatid	Spain	Vector unknown or nonexistent	Only 1 case reported; patient suffered from symptoms similar to those of VL, including pancytopenia and hepatosplenomegaly; the organism was similar to yet morphologically different from Leishmania; this species was blunt ended and had a denser kinetoplast
	Leptomonas pulexsimulantis-like organism	Brazil	No vector; a monoxenous trypanosomatid usually infecting fleas	Only 1 case reported; patient suffered from symptoms similar to those of VL, including splenomegaly and fever

^aIt is under debate as to whether L. chagasi and L. infantum are different species. Some believe that L. infantum was originally brought to the New World during the Spanish and Portuguese occupation of South America and that these species are identical.