title: Case report: Expansion of visceral leishmaniasis to the western hilly part of Nepal.
abstract: We report the first case of visceral leishmaniasis (VL) from the non-endemic western hilly region of Nepal. The patient presented with a history of high-grade fever, abdominal distension, anemia, and weight loss. The case was confirmed as VL by microscopical detection of the Leishmania species amastigote in bone marrow aspiration and by a positive result for the rK39 test. The patient was treated with 0.5-1.0 mg/kg of Amphotericin B for 14 days (total of 405 mg), and amastigotes were negative on discharge. Five months later, this patient again developed fever, abdominal distension, and anemia. Clinical and hematological examinations suggested a relapse of VL. The patient was treated with 1 mg/kg of Amphotericin B for 18 days (total of 515 mg) and was clinically improved on discharge.
authors.affiliation: Sukraraj Tropical and Infectious Diseases Hospital, Kathmandu, Nepal. basupandey@wlink.com.np
authors.forename: Basu Dev
authors.initials: BD
authors.lastname: Pandey
authors.forename: Sher Bahadur
authors.initials: SB
authors.lastname: Pun
authors.forename: Osamu
authors.initials: O
authors.lastname: Kaneko
authors.forename: Kishor
authors.initials: K
authors.lastname: Pandey
authors.forename: Kenji
authors.initials: K
authors.lastname: Hirayama
mesh_terms: D000293:Adolescent; D000666:Amphotericin B / Q000627:therapeutic use; D000981:Antiprotozoal Agents / Q000627:therapeutic use; D006801:Humans; D007898:Leishmaniasis, Visceral / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology*; D008297:Male; D009390:Nepal / Q000453:epidemiology
chemical_list: D000981:Antiprotozoal Agents; D000666:Amphotericin B