Leishmania Image of a Phlebotomus papatasi sandfly which is responsible for the vector-borne parasitic disease leishmaniasis next to an image of Leishmania sp. promastigotes from culture. This is the stage of the parasite that occurs inside the mid-gut of the sand fly. • Life cycle of Leishmania spp. Image of a bone marrow biopsy showing a macrophage containing Leishmania amastigotes. Image of a cutaneous leishmaniasis ulcer. Image of a patient with an enlarged spleen undergoing a physical exam.