American Journal of Medical Case Reports
ISSN (Print): 2374-2151 ISSN (Online): 2374-216X Website: Editor-in-chief: Samy, I. McFarlane
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American Journal of Medical Case Reports. 2017, 5(5), 126-128
DOI: 10.12691/ajmcr-5-5-6
Open AccessCase Study

A Case of African Visceral Leishmaniasis (VL) Treated with a Combination of Liposomal Amphotericin-B and oral Miltefosine

Alok Agarwal1, , Makardhwaj Sarvadaman Shrivastava1 and Amit Kumar Vishwakarma2

1Internal Medicine, Indraprastha Apollo Hospitals, New Delhi, India

2Biocon Ltd., Bangalore, India

Pub. Date: June 16, 2017

Cite this paper:
Alok Agarwal, Makardhwaj Sarvadaman Shrivastava and Amit Kumar Vishwakarma. A Case of African Visceral Leishmaniasis (VL) Treated with a Combination of Liposomal Amphotericin-B and oral Miltefosine. American Journal of Medical Case Reports. 2017; 5(5):126-128. doi: 10.12691/ajmcr-5-5-6


A 36-year-old Nigerian man was assessed for chronic recurrent fever, generalized weakness, body aches, epistaxis and bleeding gums of 3-month duration. Despite receiving treatment for suspected malaria twice and undergoing multiple courses of antibiotics for suspected infections, his symptoms persisted. Examination revealed hepatosplenomegaly, lymphadenopathy, and severe pallor. Investigations revealed severe anemia, pancytopenia, raised globulin levels. Bone marrow biopsy revealed Leishmania Donovani (LD) bodies. He received treatment with a short duration of high-dose liposomal Amphotericin B followed by outpatient oral Miltefosine to which he responded successfully.

infections visceral leishmaniasis VL Amphotericin-B Miltefosine black fever Kala-azar

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[1]  Singh, R.K., Pandey, H.P., and Sundar, S., “Visceral leishmaniasis (Kala- azar): Challenges ahead,” Indian J Med Res, 123. 331-344. Mar.2006
[2]  Herwaldt, B.L., “Leishmaniasis,” Lancet, 354. 1191-1199. Oct.1999.
[3]  Murray, H.W., Berman, J.D., Davies, C.R., and Saravia, N.G., “Advances in leishmaniasis,” Lancet, 366. 1561-1577. Oct.2005.
[4]  Sundar, S., Chakravarty, J., Agarwal, D., Rai, M., and Murray, H.W., “Single-Dose liposomal Amphotericin B for visceral leishmaniasis in India,” N Engl J Med, 362. 504-512. Feb.2010.
[5]  Sundar, S., Rai, M., Chakravarty, J., Agarwal, D., Agrawal, N., Valliant, M., et al., “New treatment approach in Indian visceral leishmaniasis: Single dose liposomal amphotericin B followed by short-course oral miltefosine,” Clin Infect Dis, 47(8). 1000-1006. Oct.2008.