We have developed a highly sensitive, simple and rapid procedure to detect Leishmania infantum within human macrophages. It only requires ficoll preparation of peripheral blood mononuclear cells from the patient, and their direct use for Leishmania kDNA amplification by polymerase chain reaction. Under these conditions, about one parasite can be detected in a one million human cell environment. Results, including those of a hybridization step to confirm the diagnosis specificity, are obtained with 24 h, a very short period as compared to current diagnostic methods. This procedure is of particular interest for early detection and early drug treatment of leishmaniasis, especially in the case of HIV coinfection. Furthermore, the method could be useful for monitoring the efficiency of new leishmaniasis treatments in infected patients.