Case report: combination therapy with liposomal amphotericin B, n-methyl meglumine antimoniate, and pentamidine isethionate for disseminated visceral leishmaniasis in a splenectomized adult patient

• Autor(a) principal: Vechi, Hareton Teixeira
• Data de Publicação: 2020
• Outros Autores: Sousa, Ana Solange Vasconcelos de, Cunha, Mirella Alves da, Shaw, Jeffrey Jon, Luz, Kleber Giovanni
• Tipo de documento: Artigo
• Idioma: eng
• Título da fonte: Repositório Institucional da UFRN
• Texto Completo: https://repositorio.ufrn.br/handle/123456789/45639
• topic: Visceral leishmaniasis; Splenectomized Adult Patient

In immunocompromised patients, visceral leishmaniasis (VL) can present with atypical clinical symptoms that include poorresponse to treatment.Nooptimal therapeuticregimen is available for such cases. In a splenectomizedmale patient, we observed a disseminated form of the disease in the liver, bone marrow, lymph nodes, and gastrointestinal tract. Therewas an apparent clinical improvementwhenhewas initiallytreatedwith liposomal amphotericin B (L-AmB), butthiswas followed by a relapse involving severe clinical symptoms. He was finally treated successfully with a combination of L-AmB, meglumine antimoniate, and pentamidine isethionate. It is important to include asplenia as an immunosuppressive condition that induces exotic VL pathologies. In such cases, combination anti-Leishmania drug therapy should be considered