Leishmania occurs globally in the tropes and subtropics and also in mediterranean areas. The transmission happens by the bite of sand flies.
There are 3 types of Leishmania. The inner (visceral) Leishmania settles in the organs. The pathogens are L. donovani, in Europe L. infanctum. The cutaneous Leishmania attacks only the skin. The pathogens are L. tropica major, L. tropica minor, L.- tropica inflantum and L- aethiopica. Leishmania attacks next to the skin also the mucous membrane. The pathogen is L. brasiliensis.