{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T18:43:13Z","timestamp":1785436993079,"version":"3.56.0"},"reference-count":55,"publisher":"MDPI AG","issue":"6","license":[{"start":{"date-parts":[[2026,5,26]],"date-time":"2026-05-26T00:00:00Z","timestamp":1779753600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Victor Babe\u0219 University of Medicine and Pharmacy Timi\u0219oara"},{"id":[{"id":"https:\/\/ror.org\/00afdp487","id-type":"ROR","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Microorganisms"],"abstract":"<jats:p>Visceral leishmaniasis (VL) is a rare but increasingly recognized parasitic infection in non-endemic European regions, including Romania. We report two cases of VL diagnosed in Timi\u0219 County, Western Romania, in 2020: a 57-year-old male presenting with fever, massive splenomegaly, and severe pancytopenia, and a 51-year-old male presenting atypically with fatigue, bicytopenia, and absence of organomegaly. Both patients were diagnosed through bone marrow aspirate examination revealing Leishmania amastigotes. Both cases were classified as imported VL, with exposure linked to endemic regions of eastern Spain (Castell\u00f3n and Val\u00e8ncia). These cases highlight the importance of maintaining a high index of clinical suspicion for VL in patients presenting with unexplained cytopenias and elevated inflammatory markers, even in the absence of classic features such as hepatosplenomegaly. The present report underscores the relevance of travel history in non-endemic regions such as Romania and the need for clinical awareness of imported VL in patients returning from endemic areas of southern Europe.<\/jats:p>","DOI":"10.3390\/microorganisms14061196","type":"journal-article","created":{"date-parts":[[2026,5,26]],"date-time":"2026-05-26T11:02:51Z","timestamp":1779793371000},"page":"1196","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Imported Visceral Leishmaniasis in Timi\u0219 County, Western Romania"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5218-9026","authenticated-orcid":false,"given":"Alin Gabriel","family":"Mihu","sequence":"first","affiliation":[{"name":"Center for Diagnosis and Study of Parasitic Diseases, Department of Infectious Disease, \u201cVictor Babes\u201d University of Medicine and Pharmacy, 300041 Timisoara, Romania"},{"name":"Department of Biology and Life Sciences, Vasile Goldis Western University of Arad, 310300 Arad, Romania"},{"name":"Patogen Preventia, 300124 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6840-9553","authenticated-orcid":false,"given":"Ioana","family":"Ionita","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, University Clinic of Hematology, \u201cVictor Babes\u201d University of Medicine and Pharmacy, No. 2 Eftimie Murgu Square, 300041 Timisoara, Romania"},{"name":"Multidisciplinary Research Center for Malignant Hemopathies, \u201cVictor Babes\u201d University of Medicine and Pharmacy, Eftimie Murgu Square 2, 300041 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mariana","family":"Patiu","sequence":"additional","affiliation":[{"name":"Department of Hematology, Ion Chiricuta Oncology Institute, 400015 Cluj-Napoca, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Coralia Adina","family":"Cotoraci","sequence":"additional","affiliation":[{"name":"Department of Medicine, Vasile Goldis Western University of Arad, 310025 Arad, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniela Adriana","family":"Oatis","sequence":"additional","affiliation":[{"name":"Center for Diagnosis and Study of Parasitic Diseases, Department of Infectious Disease, \u201cVictor Babes\u201d University of Medicine and Pharmacy, 300041 Timisoara, Romania"},{"name":"Department of Medicine, Vasile Goldis Western University of Arad, 310025 Arad, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Doina Elena","family":"Nicola","sequence":"additional","affiliation":[{"name":"Clinical Laboratory, Municipal Clinical Emergency Teaching Hospital, 300254 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6235-9076","authenticated-orcid":false,"given":"Ana Alexandra","family":"Ardelean","sequence":"additional","affiliation":[{"name":"Center for Diagnosis and Study of Parasitic Diseases, Department of Infectious Disease, \u201cVictor Babes\u201d University of Medicine and Pharmacy, 300041 Timisoara, Romania"},{"name":"Patogen Preventia, 300124 Timisoara, Romania"},{"name":"Clinical Laboratory, Municipal Clinical Emergency Teaching Hospital, 300254 Timisoara, Romania"},{"name":"Discipline of Parasitology, Department of Infectious Disease, \u201cVictor Babes\u201d University of Medicine and Pharmacy, 300041 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Liana Maria","family":"Chicea","sequence":"additional","affiliation":[{"name":"Center for Diagnosis and Study of Parasitic Diseases, Department of Infectious Disease, \u201cVictor Babes\u201d University of Medicine and Pharmacy, 300041 Timisoara, Romania"},{"name":"Department II Medical Clinic, \u201cVictor Papilian\u201d Faculty of Medicine, Lucian Blaga University of Sibiu, 550024 Sibiu, Romania"},{"name":"Internal Medicine Department, Academic Emergency Hospital, 550245 Sibiu, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1094-3729","authenticated-orcid":false,"given":"Tudor Rare\u0219","family":"Olariu","sequence":"additional","affiliation":[{"name":"Center for Diagnosis and Study of Parasitic Diseases, Department of Infectious Disease, \u201cVictor Babes\u201d University of Medicine and Pharmacy, 300041 Timisoara, Romania"},{"name":"Patogen Preventia, 300124 Timisoara, Romania"},{"name":"Clinical Laboratory, Municipal Clinical Emergency Teaching Hospital, 300254 Timisoara, Romania"},{"name":"Discipline of Parasitology, Department of Infectious Disease, \u201cVictor Babes\u201d University of Medicine and Pharmacy, 300041 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,5,26]]},"reference":[{"key":"ref_1","unstructured":"World Health Organization (2026, March 08). Leishmaniasis. Fact Sheet. Available online: https:\/\/www.who.int\/news-room\/fact-sheets\/detail\/leishmaniasis."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"100239","DOI":"10.1016\/j.microb.2025.100239","article-title":"Leishmaniasis: A Multifaceted Approach to Diagnosis, Maladies, Drug Repurposing and Way Forward","volume":"6","author":"Makarani","year":"2025","journal-title":"Microbe"},{"key":"ref_3","doi-asserted-by":"crossref","unstructured":"Mesquita, J.T., Dias, I.d.O., Tempone, A.G., and Reim\u00e3o, J.Q. (2026). Econazole Exhibits In Vitro and In Vivo Efficacy Against Leishmania amazonensis. Pharmaceuticals, 19.","DOI":"10.3390\/ph19010185"},{"key":"ref_4","unstructured":"Weller, P.F. (2024). Visceral Leishmaniasis: Clinical Manifestations and Diagnosis. UpToDate, UpToDate Inc.. Available online: https:\/\/www.uptodate.com\/contents\/visceral-leishmaniasis-clinical-manifestations-and-diagnosis?search=visceral%20leishmaniasis&source=search_result&selectedTitle=1~51&usage_type=default&display_rank=1#H2."},{"key":"ref_5","doi-asserted-by":"crossref","unstructured":"Maia, C., Concei\u00e7\u00e3o, C., Pereira, A., Rocha, R., Ortu\u00f1o, M., Mu\u00f1oz, C., Jumakanova, Z., P\u00e9rez-Cutillas, P., \u00d6zbel, Y., and T\u00f6z, S. (2023). The Estimated Distribution of Autochthonous Leishmaniasis by Leishmania Infantum in Europe in 2005\u20132020. PLoS Negl. Trop. Dis., 17.","DOI":"10.1371\/journal.pntd.0011497"},{"key":"ref_6","doi-asserted-by":"crossref","unstructured":"Costa, C.H.N., Chang, K.-P., Costa, D.L., and Cunha, F.V.M. (2023). From Infection to Death: An Overview of the Pathogenesis of Visceral Leishmaniasis. Pathogens, 12.","DOI":"10.3390\/pathogens12070969"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"1123","DOI":"10.1586\/14787210.2015.1056160","article-title":"Leishmaniasis: Diagnostic Issues in Europe","volume":"13","author":"Torpiano","year":"2015","journal-title":"Expert. Rev. Anti-Infect. Ther."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"79","DOI":"10.1016\/j.idc.2018.10.005","article-title":"Visceral Leishmaniasis: Recent Advances in Diagnostics and Treatment Regimens","volume":"33","author":"Diro","year":"2019","journal-title":"Infect. Dis. Clin. N. Am."},{"key":"ref_9","doi-asserted-by":"crossref","unstructured":"Alvar, J., V\u00e9lez, I.D., Bern, C., Herrero, M., Desjeux, P., Cano, J., Jannin, J., den Boer, M., and WHO Leishmaniasis Control Team (2012). Leishmaniasis Worldwide and Global Estimates of Its Incidence. PLoS ONE, 7.","DOI":"10.1371\/journal.pone.0035671"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"107441","DOI":"10.1016\/j.actatropica.2024.107441","article-title":"Accuracy Evaluation of Diagnostic Methods for Visceral Leishmaniasis in Adult Patients with and without HIV Infection: Clinical Management Implications","volume":"260","author":"Druzian","year":"2024","journal-title":"Acta Trop."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"e0358-2022","DOI":"10.1590\/0037-8682-0358-2022","article-title":"Serology for Visceral Leishmaniasis: How Trusty Is the Accuracy Reported by the Manufacturers?","volume":"56","author":"Freire","year":"2023","journal-title":"Rev. Soc. Bras. Med. Trop."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"443","DOI":"10.1007\/s40291-018-0343-y","article-title":"Molecular Diagnosis of Visceral Leishmaniasis","volume":"22","author":"Sundar","year":"2018","journal-title":"Mol. Diagn. Ther."},{"key":"ref_13","first-page":"2002028","article-title":"Surveillance of Leishmaniasis Cases from 15 European Centres, 2014 to 2019: A Retrospective Analysis","volume":"27","author":"Davidsson","year":"2022","journal-title":"Euro Surveill."},{"key":"ref_14","unstructured":"European Centre for Disease Prevention and Control (ECDC) (2022). Surveillance, Prevention and Control of Leishmaniases in the European Union and Its Neighbouring Countries, ECDC. Available online: https:\/\/www.ecdc.europa.eu\/sites\/default\/files\/documents\/leishmaniasis-surveillance-eu.pdf."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"100150","DOI":"10.1016\/j.crpvbd.2023.100150","article-title":"Knock, Knock, Knocking on Europe\u2019s Door: Threat of Leishmaniasis in Europe with a Focus on Turkey","volume":"4","year":"2023","journal-title":"Curr. Res. Parasitol. Vector Borne Dis."},{"key":"ref_16","unstructured":"World Health Organization (2026, March 08). Global Leishmaniasis Surveillance Updates 2023: 3 Years of the NTD Road Map. Epidemiological Record. Available online: https:\/\/www.who.int\/publications\/i\/item\/who-wer-9945-653-669."},{"key":"ref_17","doi-asserted-by":"crossref","unstructured":"Mihu, A.G., Patiu, M., Dima, D.M., Oatis, D.A., Cismaru, C.M., Lighezan, R., and Olariu, T.R. (2025). Visceral Leishmaniasis in a 25-Year-Old Female Kidney Transplant Recipient from a Non-Endemic Region: A Case Report from Romania. Microorganisms, 13.","DOI":"10.3390\/microorganisms13020403"},{"key":"ref_18","doi-asserted-by":"crossref","unstructured":"Birlutiu, V., Iancu, G., Birlutiu, R.-M., and Florescu, S.A. (2025). How Common Is Imported Cutaneous Leishmaniasis in Romania? Two Case Reports. Microorganisms, 13.","DOI":"10.3390\/microorganisms13061207"},{"key":"ref_19","first-page":"101","article-title":"Leishmaniasis\u2014An Unusual Cause of Splenomegaly in Romania","volume":"118","author":"Alexa","year":"2014","journal-title":"Rev. Med. Chir. Soc. Med. Nat. Iasi"},{"key":"ref_20","doi-asserted-by":"crossref","unstructured":"Daraban Bocaneti, F., Ivanescu, L.M., Miron, L., Tanase, O.I., and Dascalu, M.A. (2022). An Overview on Leishmaniasis in Romania: Diagnosis and Therapeutics. Trop. Med. Infect. Dis., 7.","DOI":"10.3390\/tropicalmed7110334"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"35","DOI":"10.1016\/j.tmaid.2008.10.002","article-title":"Importation of Visceral Leishmaniasis in Returning Romanian Workers from Spain","volume":"7","author":"Neghina","year":"2009","journal-title":"Travel. Med. Infect. Dis."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"906","DOI":"10.4269\/ajtmh.13-0070","article-title":"Leishmaniases in Greece","volume":"89","author":"Ntais","year":"2013","journal-title":"Am. J. Trop. Med. Hyg."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"19505","DOI":"10.2807\/ese.15.10.19505-en","article-title":"Leishmaniasis Emergence in Europe","volume":"15","author":"Ready","year":"2010","journal-title":"Euro Surveill."},{"key":"ref_24","doi-asserted-by":"crossref","unstructured":"Vutova, K., Yancheva-Petrova, N., Tchipeva, R., and Velev, V. (2024). Autochthonous and Imported Visceral Leishmaniasis in Bulgaria-Clinical Experience and Treatment of Patients. Pathogens, 13.","DOI":"10.3390\/pathogens13030205"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"185","DOI":"10.1016\/j.rvsc.2019.01.018","article-title":"A Historical Review on Vector Distribution and Epidemiology of Human and Animal Leishmanioses in Eastern Europe","volume":"123","author":"Mihalca","year":"2019","journal-title":"Res. Vet. Sci."},{"key":"ref_26","first-page":"105","article-title":"Two Cases of Kala-Azar Observed in Romania","volume":"1920","author":"Manicatide","year":"1919","journal-title":"Bull. Sect. Sci. Acad. Roum."},{"key":"ref_27","first-page":"391","article-title":"A Case of Visceral Leishmaniasis in Oltenia Region (Romania)","volume":"51","author":"Dobrea","year":"2010","journal-title":"Rom. J. Morphol. Embryol."},{"key":"ref_28","first-page":"49","article-title":"Two Case Reports on Visceral Leishmaniasis Diagnosed in Romania","volume":"72","author":"Teodorescu","year":"2013","journal-title":"Roum. Arch. Microbiol. Immunol."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"48","DOI":"10.1093\/clinids\/19.1.48","article-title":"Gastrointestinal Leishmaniasis in Human Immunodeficiency Virus-Infected Patients: Report of Five Cases and Review","volume":"19","author":"Laguna","year":"1994","journal-title":"Clin. Infect. Dis."},{"key":"ref_30","doi-asserted-by":"crossref","unstructured":"Wang, H., Li, J., and Huang, W. (2025). Case Report: Fever of Unknown Origin with Hemophagocytic Lymphohistiocytosis and Intestinal Hemorrhage-a Successfully Treated Case of Severe Visceral Leishmaniasis. Front. Med., 12.","DOI":"10.3389\/fmed.2025.1663551"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"1101","DOI":"10.1093\/qjmed\/77.2.1101","article-title":"Visceral Leishmaniasis in HIV Infection and AIDS: Clinical Features and Response to Therapy","volume":"77","author":"Peters","year":"1990","journal-title":"Q. J. Med."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"54","DOI":"10.1097\/00005792-200101000-00006","article-title":"Visceral Leishmaniasis in Human Immunodeficiency Virus (HIV)-Infected and Non-HIV-Infected Patients. A Comparative Study","volume":"80","author":"Pintado","year":"2001","journal-title":"Medicine"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"38","DOI":"10.1097\/RHU.0b013e3181c8aa33","article-title":"An Atypical Presentation of Visceral Leishmaniasis Infection in a Patient with Rheumatoid Arthritis Treated with Infliximab","volume":"16","author":"Kritikos","year":"2010","journal-title":"J. Clin. Rheumatol."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"158","DOI":"10.1016\/j.ejim.2006.07.028","article-title":"A Rare Presentation of Visceral Leishmaniasis without Fever or Splenomegaly in an Elderly Person","volume":"18","author":"Mohan","year":"2007","journal-title":"Eur. J. Intern. Med."},{"key":"ref_35","first-page":"e87993","article-title":"Visceral Leishmaniasis with Massive Pulmonary Involvement: A Case Report","volume":"6","author":"Dehghani","year":"2019","journal-title":"Int. J. Infect."},{"key":"ref_36","doi-asserted-by":"crossref","unstructured":"Shiferaw, E., Murad, F., Tigabie, M., Abebaw, M., Alemu, T., Abate, S., Mohammed, R., Yeshanew, A., and Tajebe, F. (2021). Hematological Profiles of Visceral Leishmaniasis Patients before and after Treatment of Anti-Leishmanial Drugs at University of Gondar Hospital; Leishmania Research and Treatment Center Northwest, Ethiopia. BMC Infect. Dis., 21.","DOI":"10.1186\/s12879-021-06691-7"},{"key":"ref_37","doi-asserted-by":"crossref","unstructured":"Dos-Santos, W.L.C., Pagliari, C., Santos, L.G., Almeida, V.A., e Silva, T.L.V., Coutinho, J.d.J., Souza, T., Duarte, M.I.S., de Freitas, L.A.R., and Costa, C.H.N. (2014). A Case of Conventional Treatment Failure in Visceral Leishmaniasis: Leukocyte Distribution and Cytokine Expression in Splenic Compartments. BMC Infect. Dis., 14.","DOI":"10.1186\/1471-2334-14-491"},{"key":"ref_38","doi-asserted-by":"crossref","unstructured":"Hermida, M.E.-R., de Melo, C.V.B., Lima, I.D.S., Oliveira, G.G.d.S., and Dos-Santos, W.L.C. (2018). Histological Disorganization of Spleen Compartments and Severe Visceral Leishmaniasis. Front. Cell. Infect. Microbiol., 8.","DOI":"10.3389\/fcimb.2018.00394"},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"342","DOI":"10.4269\/ajtmh.21-0376","article-title":"Splenectomy in Patients with Visceral Leishmaniasis Resistant to Conventional Therapy and Secondary Prophylaxis: A Retrospective Cohort","volume":"107","author":"Reinaldo","year":"2022","journal-title":"Am. J. Trop. Med. Hyg."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"78","DOI":"10.1007\/s12288-010-0027-1","article-title":"Hematologic Changes in Visceral Leishmaniasis\/Kala Azar","volume":"26","author":"Varma","year":"2010","journal-title":"Indian J. Hematol. Blood Transfus."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"e01844","DOI":"10.1128\/mBio.01844-14","article-title":"Clinical Severity of Visceral Leishmaniasis Is Associated with Changes in Immunoglobulin g Fc N-Glycosylation","volume":"5","author":"Gardinassi","year":"2014","journal-title":"mBio"},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"35","DOI":"10.1016\/S0001-706X(99)00089-3","article-title":"High Levels of C-Reactive Protein in the Peripheral Blood during Visceral Leishmaniasis Predict Subsequent Development of Post Kala-Azar Dermal Leishmaniasis","volume":"75","author":"Gasim","year":"2000","journal-title":"Acta Trop."},{"key":"ref_43","first-page":"951","article-title":"Laboratory Diagnosis of Visceral Leishmaniasis","volume":"9","author":"Sundar","year":"2002","journal-title":"Clin. Diagn. Lab. Immunol."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"135","DOI":"10.1186\/1756-3305-7-135","article-title":"Autochthonous Canine Leishmaniasis in Romania: Neglected or (Re)Emerging?","volume":"7","author":"Mircean","year":"2014","journal-title":"Parasites Vectors"},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"297","DOI":"10.1186\/s13071-016-1583-5","article-title":"The Quest for Canine Leishmaniasis in Romania: The Presence of an Autochthonous Focus with Subclinical Infections in an Area Where Disease Occurred","volume":"9","author":"Dumitrache","year":"2016","journal-title":"Parasites Vectors"},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"588","DOI":"10.1089\/vbz.2011.0906","article-title":"First Record of Autochthonous Canine Leishmaniasis in Hungary","volume":"12","author":"Balogh","year":"2012","journal-title":"Vector-Borne Zoonotic Dis."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"247","DOI":"10.1186\/s13071-019-3507-7","article-title":"Updates on the Distribution and Diversity of Sand Flies (Diptera: Psychodidae) in Romania","volume":"12","author":"Cazan","year":"2019","journal-title":"Parasites Vectors"},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"1371","DOI":"10.1007\/s00436-019-06296-9","article-title":"Seasonal Dynamics of a Population of Phlebotomus (Larroussius) Perfiliewi Parrot, 1930 (Diptera: Psychodidae) in North-Eastern Romania","volume":"118","author":"Cazan","year":"2019","journal-title":"Parasitol. Res."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"189","DOI":"10.15666\/aeer\/1102_189208","article-title":"The Effect of Climate Change on the Potential Distribution of the European Phlebotomus Species","volume":"11","author":"Hufnagel","year":"2013","journal-title":"Appl. Ecol. Environ. Res."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"13325","DOI":"10.1038\/s41598-017-13822-1","article-title":"Modeling the Climatic Suitability of Leishmaniasis Vector Species in Europe","volume":"7","author":"Koch","year":"2017","journal-title":"Sci. Rep."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"461","DOI":"10.1186\/s13071-018-3019-x","article-title":"Ecological Niche Modeling Predicting the Potential Distribution of Leishmania Vectors in the Mediterranean Basin: Impact of Climate Change","volume":"11","author":"Chalghaf","year":"2018","journal-title":"Parasites Vectors"},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"100971","DOI":"10.1016\/j.lanepe.2024.100971","article-title":"A Climatic Suitability Indicator to Support Leishmania Infantum Surveillance in Europe: A Modelling Study","volume":"43","author":"Carvalho","year":"2024","journal-title":"Lancet Reg. Health Eur."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"563","DOI":"10.1080\/14787210.2020.1751611","article-title":"The Enemy at Home: Leishmaniasis in the Mediterranean Basin, Italy on the Focus","volume":"18","author":"Gianchecchi","year":"2020","journal-title":"Expert Rev. Anti-Infect. Ther."},{"key":"ref_54","first-page":"555","article-title":"Review of the current situation and the risk factors of Leishmania infantum in Spain","volume":"86","year":"2012","journal-title":"Rev. Esp. Salud Publica"},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"1404","DOI":"10.1111\/tbed.14107","article-title":"Autochthonous and imported tegumentary leishmaniasis in Catalonia (Spain): Aetiological evolution in the last four decades and usefulness of different typing approaches based on biochemical, molecular and proteomic markers","volume":"69","author":"Ballart","year":"2022","journal-title":"Transbound. Emerg. Dis."}],"container-title":["Microorganisms"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2076-2607\/14\/6\/1196\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,27]],"date-time":"2026-05-27T11:29:49Z","timestamp":1779881389000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2076-2607\/14\/6\/1196"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5,26]]},"references-count":55,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2026,6]]}},"alternative-id":["microorganisms14061196"],"URL":"https:\/\/doi.org\/10.3390\/microorganisms14061196","relation":{},"ISSN":["2076-2607"],"issn-type":[{"value":"2076-2607","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5,26]]}}}