Cure of antimony-unresponsive Indian post-kala-azar dermal leishmaniasis with oral miltefosine.
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.
Sundar
Shyam
S
Kala-azar Medical Research Center, Department of Medicine, Institute of Medical Sciences, Banaras Hindu University, Varanasi 221 005, India. shyam_vns@sify.com
Kumar
Kailash
K
Chakravarty
Jaya
J
Agrawal
Dipti
D
Agrawal
Shrinkhla
S
Chhabra
Amit
A
Singh
Vikram
V
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
D000981:Antiprotozoal Agents; D010767:Phosphorylcholine; C039128:miltefosine; D000967:Antimony Sodium Gluconate