After a trip to several South American countries, a middle-aged man becomes ill. He becomes anemic, loses weight, and runs a fev
er. The clinician notes a recently healed sore near his nose. Microscopic examination of a blood smear does not reveal anything other than the anemia. What parasitic infection is consistent with this scenario?
Leishmaniasis is transmitted through the bite of sandflies. It is caused by protozoan Leishmania parasites. According to the World Health Organization, In South America the epidemiology of leishmaniasis is complex and there are different transmission cycles, hosts, and clinical manifestations of the disease. There are also differential responses to therapy and a number of circulating Leishmania species. Brazil represents over 90% of the visceral leishmaniasis cases in South America which is the most lethal expression of the disease.
It is illegal if to drink and drive. If detectable amount of alcohol is found in your system then you could be fined for this. If you are caught for the first time then your license can be suspended for 60 days. Fine up to 500 dollars, 20-40 hours of community service and mandatory alcohol-awareness classes are other types of penalties that one can face.
