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It is important to have a diagnostic confirmation of leishmaniasis before starting any medication because treating this disease is difficult and is usually related with adverse effects. The main diagnostic data comes from the clinical exam and the epidemiology. However, the definite diagnosis requires additional tests. The main diagnostic tests are parasitological, immunological, histopathological/ immunopathological and molecular techniques. Most parasitological methods allow the isolation of viable parasites; however, they are technically complicated and have low sensitivities. The immunological methods are frequently used, but their utility is limited in endemic areas. The histopathological/immunopathological techniques allow the observation of the parasite and the inflammatory infiltrate; but the histopathological techniques have low sensitivities. Molecular methods are the most sensitive and specific and allow the identification of species and strains; however, their complexity and related costs limit their routine application in clinical laboratories. In the future, molecular methods will be the new diagnostic gold standard.
