Human leishmanial infections can result in 2 main forms of disease, cutaneous leishmaniasis and visceral leishmaniasis (kala-azar). The factors determining the form of disease include leishmanial species, geographic location, and immune response of the host.

• Cutaneous leishmaniasis is characterized by one or more cutaneous lesions on areas where sandflies have fed.
• Persons who have cutaneous leishmaniasis have one or more sores on their skin.
• The sores can change in size and appearance over time. They often end up looking somewhat like a volcano, with a raised edge and central crater.
• A scab covers some sores.
• The sores can be painless or painful.
• Some people have swollen glands near the sores (for example, in the armpit if the sores are on the arm or hand).
• People with cutaneous leishmaniasis usually develop skin sores within a few weeks (sometimes as long as months) of when they were bitten.

• Persons who have visceral leishmaniasis usually have fever, weight loss, and an enlarged spleen and liver (usually the spleen is bigger than the liver). Some patients have swollen glands.
• People with visceral leishmaniasis usually become sick within several months (rarely as long as years) of when they were bitten.
• The symptoms of leishmaniasis are skin sores which erupt weeks to months after the person affected is bitten by sand flies.
• Other consequences, which can become manifest anywhere from a few months to years after infection, include fever, damage to the spleen and liver, and anaemia.

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