Reasearch Awards nomination

Email updates

Keep up to date with the latest news and content from Journal of Medical Case Reports and BioMed Central.

Open Access Case report

Recurrent visceral leishmaniasis in an immunocompetent patient: a case report

Maria Lagadinou1, Dimitra Dimitropoulou2, Stelios F Assimakopoulos1*, George Davoulos1 and Markos Marangos2

Author Affiliations

1 Department of Internal Medicine, University Hospital of Patras, Rion-Patras 26504, Greece

2 Division of Infectious Diseases, Department of Internal Medicine, University Hospital of Patras, Rion-Patras 26504, Greece

For all author emails, please log on.

Journal of Medical Case Reports 2013, 7:68  doi:10.1186/1752-1947-7-68

Published: 14 March 2013

Abstract

Introduction

Current treatment options for visceral leishmaniasis (pentavalent antimony, amphotericin B, liposomal amphotericin B and mitelfosine) achieve long-term clinical cure in the majority of immunocompetent patients. Disease relapse is usually provoked by T-cell number or function impairment (corticosteroid or cytotoxic therapy, transplant recipients, advanced human immunodeficiency virus disease).

Case presentation

We report a case of visceral leishmaniasis with multiple relapses in a 75-year-old Greek immunocompetent man. Visceral leishmaniasis relapses occurred despite appropriate treatment with liposomal amphotericin B 3mg/kg/day on days one to five, 14 and 21 (for the first episode and the first relapse) and mitelfosine 150mg/day for 28 days (for the second relapse). The third relapse was treated with high-dose liposomal amphotericin B (10mg/kg for two consecutive days), followed by a secondary prophylaxis of 3mg/kg once per month, which prevented disease reappearance during one year of follow-up.

Conclusion

An unusual case of recurrent visceral leishmaniasis in an older immunocompetent patient was treated with high-dose liposomal amphotericin B and a monthly prophylaxis with no evidence of a relapse after one year of follow-up.

Keywords:
Leishmaniasis; Recurrent; Immunocompetent; Liposomal amphotericin B