Last reviewed 01/2018
Promastigotes in the sandfly change into amastigotes upon inoculation into a host. Macrophages phagocytose the amastigotes. The leishmania replicate within the macrophages, resulting in granuloma formation.
Activated T-cells are present, resulting in a positive leishmanin test, but despite this parasite replication continues.
Typically the infection is cleared after months of inflammation.