n.
Human protozoal infection spread by the bite of a bloodsucking sand fly.
It occurs worldwide but is especially prevalent in tropical areas. It is caused by various species of the flagellate protozoan Leishmania , which infect rodents and canines. Visceral leishmaniasis, or kala-azar, occurs throughout the world but is especially prevalent in the Mediterranean area, Africa, Asia, and Latin America; it affects the liver, spleen, and bone marrow and is usually fatal if not treated. Cutaneous leishmaniasis is endemic in areas around the Mediterranean, in central and northern Africa, and in southern and western Asia; it is also found in Central and South America and parts of the southern U.S. It is characterized by lesions on the skin of the legs, feet, hands, and face, most of which heal spontaneously after many months.