Leishmania species are intracellular protozoan parasites that spend a portion of their life cycle in the midgut of sand flies and the remainder in the tissues of mammals. These parasites, which cause a class of human disorders known as leishmaniasis, live mostly in macrophages, where they multiply and survive by employing a variety of defense mechanisms against the oxidative stress and acidity generated by these immune cells. To help control their reaction to heat stress, they also produce heat shock proteins. Furthermore, the promastigote form has a glycocalyx that is necessary for colonizing the gut wall of the sand fly and completing its life cycle. Consequently, a variety of virulence factors contribute to the parasite's pathogenicity. Clinical signs and symptoms vary depending on the species of Leishmania and the host's immune system. In cases of cutaneous leishmaniasis, the symptoms may be limited to the skin, but if left untreated, they may spread to internal organs and be lethal.
