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<p>Leishmania<br>Captain Mikelle Kuehn, USAF, DC and Commander James Castle, DC, USN<br><br>Background<br>Skin conditions and infections have been a common problem within the U.S. military population, particularly during and soon after times of deployment. With the recent increase in troop deployment to the Middle East and Persian Gulf regions, concern over cutaneous leishmaniasis has also increased as military personnel return to the U.S. with the disease. Interestingly, trends in leishmania infection in military personnel can be seen from World War II through the Gulf War in 1990 and 1991, to the present operations in Iraq and Afghanistan. During World War II, a high incidence of leishmaniasis was seen among those deployed to the Persian Gulf, while the Gulf War saw very few cases reported out of the nearly 700,000 troops deployed to the same area. Only 12 cases of visceral leishmaniasis and 19 cases of cutaneous leishmaniasis resulting from Gulf War deployments were diagnosed. Decreased rates of infection are thought to be due to use of insect repellent and insecticides, the time of year (cooler weather), and troop location (the open desert as opposed to urban areas or oases where the primary rodent hosts reside.) <br><br>In contrast to the Gulf War, the present conflict in Iraq has garnered 522 documented cases of cutaneous leishmaniasis in military personnel deployed to SW and Central Asia between August 2002 and February 2004. Military pathologists are gaining valuable experience in the diagnosis of the disease, however it is equally important that military clinicians be able to identify potential leishmaniasis cases and to include the disease within an appropriate differential diagnosis. It is possible that a military dentist may be the first clinician to evaluate a patient with leishmaniasis as mucocutaneous leishmaniasis may be the initial or only presenting sign.
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<br>Subjects: Afghanistan ; leishmaniasis ; Iraq</div>
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U.S. Navy. Naval Postgraduate Dental School</div>
<dl><dd><a rel="nofollow" class="external free" href="https://archive.org/details/04007Leishmania">https://archive.org/details/04007Leishmania</a></dd>
<dd><a rel="nofollow" class="external free" href="https://archive.org/download/04007Leishmania/04_-_007%20Leishmania.pdf">https://archive.org/download/04007Leishmania/04_-_007%20Leishmania.pdf</a></dd></dl>