A rare case of Visceral leishmaniasis with multiple relapse and multi-drug unresponsive: successfully treated with combination therapy

  • Nawin Kumar
  • Prabhat Kumar Sinha
  • Krishna Pandey
  • Neena Verma
  • Chandra Shekhar Lal
  • Alok Ranjan
  • Rakesh Bihari Verma
  • Pradeep Das
Case Report


Case We report a 32-year old relapse case of Visceral leishmaniasis, treated with Paromomycin who belonged from a endemic zone of Bihar state, India. After confirmation, he was treated with Amphotericin B, followed by Liposomal Amphotericin B in full course and even in higher dose. But after each therapy, the patient either did not responded or relapsed after treatment. Ultimately, the patient was successfully treated with combination therapy of Liposomal amphotericin B and Miltefosine without any relapse. Conclusion The multi-drug unresponsive Visceral leishmaniasis cases could pose a major threat to treatment strategy in the elimination program. In such situation, combination therapy seems to be a better approach that needs to be explored.


Visceral leishmaniasis Paromomycin Amphotericin B Liposomal amphotericin B Miltefosine Combination therapy 



The authors are thankful to the technical and nursing staffs for their support during the patient management.

Conflict of interest



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Copyright information

© Springer Science+Business Media B.V. 2011

Authors and Affiliations

  • Nawin Kumar
    • 1
  • Prabhat Kumar Sinha
    • 1
  • Krishna Pandey
    • 1
  • Neena Verma
    • 2
  • Chandra Shekhar Lal
    • 3
  • Alok Ranjan
    • 4
  • Rakesh Bihari Verma
    • 5
  • Pradeep Das
    • 6
  1. 1.Division of Clinical MedicineRMRIMS (ICMR)PatnaIndia
  2. 2.Division of PathologyRMRIMS (ICMR)PatnaIndia
  3. 3.Division of BiochemistryRMRIMS (ICMR)PatnaIndia
  4. 4.Division of Epidemiology & BiostatisticsRMRIMS (ICMR)PatnaIndia
  5. 5.Division of BiostatisticsRMRIMS (ICMR)PatnaIndia
  6. 6.Division of Molecular BiologyRMRIMS (ICMR)PatnaIndia

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