Gold mining area merchant being cared for leishmaniasis, a disease caused by protozoan parasites and transmitted by the bite of certain species of sand fly. Santarem Municipal Hospital, Para State, Brazil. 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 manifest anywhere from a few months to years after infection, include fever, damage to the spleen and liver, and anaemia.