Publicação
Case report: combination therapy with liposomal amphotericin B, n-methyl meglumine antimoniate, and pentamidine isethionate for disseminated visceral leishmaniasis in a splenectomized adult patient
| Resumo: | 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 |
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| Autores principais: | Vechi, Hareton Teixeira |
| Outros Autores: | Sousa, Ana Solange Vasconcelos de; Cunha, Mirella Alves da; Shaw, Jeffrey Jon; Luz, Kleber Giovanni |
| Assunto: | Visceral leishmaniasis Splenectomized Adult Patient |
| Ano: | 2022 |
| País: | Brasil |
| Tipo de documento: | artigo |
| Tipo de acesso: | acesso aberto |
| Instituição associada: | IBICT |
| Idioma: | inglês |
| Origem: | Oasisbr |
| Resumo: | 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 |
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