Treatment of visceral leishmaniasis with intravenous pentamidine and oral fluconazole in an HIV-positive patient with chronic renal failure--a case report and brief review of the literature.
We report the case of an HIV-positive patient with visceral leishmaniasis and several relapses after treatment with the two first-line anti-leishmanial drugs, liposomal amphotericin B and miltefosine. End-stage renal failure occurred in 2007 when the patient was on long-term treatment with miltefosine. A relapse of leishmaniasis in 2008 was successfully treated with a novel combination regimen of intravenous pentamidine and oral fluconazole. Secondary prophylaxis with fluconazole monotherapy did not prevent parasitological relapse of leishmaniasis.
Rybniker
Jan
J
1st Department of Internal Medicine, University of Cologne, 50924 Cologne, Germany.
Goede
Valentin
V
Mertens
Jessica
J
Ortmann
Monika
M
Kulas
Wolfgang
W
Kochanek
Matthias
M
Benzing
Thomas
T
Arribas
José R
JR
Fätkenheuer
Gerd
G
D017088:AIDS-Related Opportunistic Infections / Q000150:complications / Q000188:drug therapy*; D000284:Administration, Oral; D000981:Antiprotozoal Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D004359:Drug Therapy, Combination; D015725:Fluconazole / Q000008:administration & dosage / Q000627:therapeutic use*; D006679:HIV Seropositivity / Q000150:complications; D006801:Humans; D007275:Injections, Intravenous; D007676:Kidney Failure, Chronic / Q000150:complications; D007893:Leishmania donovani; D007898:Leishmaniasis, Visceral / Q000188:drug therapy* / Q000209:etiology; D008297:Male; D008875:Middle Aged; D010419:Pentamidine / Q000008:administration & dosage / Q000627:therapeutic use*
D000981:Antiprotozoal Agents; D010419:Pentamidine; D015725:Fluconazole