- Spread by sand-fly bite
- Widespread throughout subtropics→ Africa, Central & South America, India, Mediterranean basin, Asia, Middle East
- Cutaneous: papule→ nodule→ painless raised & indurated ulcers that don't heal over weeks to mos
- Visceral→ can be silent, or cause fevers, sweats, chills, wt loss, adnenopathy, organomegaly