One day, you may notice that there is a bite that simply will not heal.

As the days pass, it may become red and begin to weep.

Now it’s a small sore.

Perhaps you dab at it with a bandage throughout the day. Perhaps you smear it with any number of ointments or unguents, maybe applying a poultice or two for good measure. Perhaps you try drying it out, setting it in what sun you can get. Perhaps you also try poking at it with something, because it really looks awfully squishy… and strangely, the poking doesn’t hurt at all…

And still it won’t heal…

And now it’s spreading… so that it looks as if your skin is gradually, wetly melting from the bite outwards…

Now is the time to worry:

You may have cutaneous leishmaniasis.

If you get a potentially disfiguring and possibly fatal tropical disease like cutaneous leishmaniasis, there are a few things you should remember:

1) Nothing you put on it will help… you need a doctor.  Now.

2) And I mean right now. SEE A DOCTOR NOW. If you value the smooth integrity of the skin around the area where your sore has appeared, and they can appear anywhere, DO NOT travel back to whatever country you came from because you think they have ‘better medical care’. In this case, they do not. The doctors near your field site will diagnose you right away. They’ve seen it. They know what to do. The doctors in your home country will be persnickety about your ‘self-diagnosing’. They know absolutely nothing about tropical diseases. And so they will take weeks sending those samples to the CDC to be identified, which they have to do before they can administer treatment because:

3) Since the parasite is actually a systemic infection, even though the only outward sign is the slowly spreading sore, it is actually infiltrating many parts of your body. It is in your spleen, your liver, and your blood. The only way to really get rid of it is to poison yourself. With antimony. A heavy metal. For a month. During which time you will be both bedridden, nauseated, and in pain… but look on the bright side: at least the Leishmania will be stopped before it can begin eating the cartilage under your face.

So if you have a curious sore that is painless and yet slowly melting away the skin around it, call a doctor immediately, and get ready.

It’s going to be a very long month.