title: Cure of antimony-unresponsive Indian post-kala-azar dermal leishmaniasis with oral miltefosine.
abstract: We report the case of a patient with Indian post-kala-azar dermal leishmaniasis (PKDL) who failed to show any response to 2 months' treatment with sodium stibogluconate. Six months later he was treated with oral miltefosine on a compassionate basis as an off-label indication. Miltefosine was given 100mg daily in divided doses for an initial 8 weeks. Due to insufficient response, the treatment was extended up to a total of 12 weeks. The patient showed an excellent response to treatment, and after 12 months of follow-up there was complete healing of all cutaneous lesions. Oral miltefosine appears to be an important alternative for the treatment of PKDL in India and confirmatory studies in controlled clinical trials are needed.
authors.affiliation: Kala-azar Medical Research Center, Department of Medicine, Institute of Medical Sciences, Banaras Hindu University, Varanasi 221 005, India. shyam_vns@sify.com
authors.forename: Shyam
authors.initials: S
authors.lastname: Sundar
authors.forename: Kailash
authors.initials: K
authors.lastname: Kumar
authors.forename: Jaya
authors.initials: J
authors.lastname: Chakravarty
authors.forename: Dipti
authors.initials: D
authors.lastname: Agrawal
authors.forename: Shrinkhla
authors.initials: S
authors.lastname: Agrawal
authors.forename: Amit
authors.initials: A
authors.lastname: Chhabra
authors.forename: Vikram
authors.initials: V
authors.lastname: Singh
mesh_terms: D000284:Administration, Oral; D000328:Adult; D000967:Antimony Sodium Gluconate / Q000008:administration & dosage*; D000981:Antiprotozoal Agents / Q000008:administration & dosage*; D006801:Humans; D007275:Injections, Intravenous; D016773:Leishmaniasis, Cutaneous / Q000188:drug therapy* / Q000209:etiology; D007898:Leishmaniasis, Visceral / Q000150:complications*; D008297:Male; D010767:Phosphorylcholine / Q000008:administration & dosage / Q000031:analogs & derivatives*; D016896:Treatment Outcome
chemical_list: D000981:Antiprotozoal Agents; D010767:Phosphorylcholine; C039128:miltefosine; D000967:Antimony Sodium Gluconate