Cutaneous leishmaniasis in Moroccan children: about 12 cases

During the blood meal in the exposed areas of human body, female sand flies injects promastigotes in their infective stage into the skin; The parasites are captured by phagocytes in dermal tissue, initially by short-lived neutrophils (the first leukocyte recruited to the bite site that subsequently enter into apoptosis) and subsequently also by macrophages. In addition to phagocytized parasites, macrophages also phagocytize infected apoptotic neutrophils. Inside the macrophages, promastigotes establish an intracellular residence and transform into aflagellate amastigotes, where they multiply, and are released upon cell lysis, when too many amastigotes are present in the phagolysosome, resulting in reinfection of other cells. The cycle is completed when other sandfly ingest infected phagocytes during the blood meal. Inside the vectors, amastigotes are converted into promastigotes in hindgut/midgut. At this site, parasites proliferate and differentiate into infective promastigotes and migrate to the salivary glands of the sand fly and perpetuate its life cycle.