Khodabandeh Mahmoud, Rostami Ali, Borhani Katayoun, Gamble H Ray, Mohammadi Mohsen
Department of Infectious Diseases, Pediatrics Center of Excellence, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran.
Infectious Diseases and Tropical Medicine Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran.
Parasitol Int. 2019 Oct;72:101934. doi: 10.1016/j.parint.2019.101934. Epub 2019 May 24.
This report describes the first case of visceral leishmaniasis (VL) resistant to pentavalent antimonials and also the first use of combinational therapy in Iran. The patient was a two-year old boy, from a non-endemic area for leishmaniasis in northern Iran, presenting with pentavalent antimonial resistant VL. Additional treatment with conventional and liposomal amphotericin B was not effective. A complete cure was achieved following a three week treatment with liposomal amphotericin B (5 mg/kg/day for 5 days, then on the 14th and 21st days), allopurinol (25 mg/day for 5 days, then on the 14th and 21st days) and interferon gamma (50 μg/m subcutaneously three times weekly). Our results suggest a need for further studies to identify resistant Leishmania species and their susceptibility to different treatment regimens.
本报告描述了首例对五价锑剂耐药的内脏利什曼病（VL）病例，也是伊朗首次使用联合疗法。该患者是一名两岁男孩，来自伊朗北部利什曼病非流行区，患有对五价锑剂耐药的VL。使用传统两性霉素B和脂质体两性霉素B进行额外治疗均无效。在接受为期三周的治疗后实现了完全治愈，治疗方案为脂质体两性霉素B（5mg/kg/天，共5天，然后在第14天和第21天）、别嘌呤醇（25mg/天，共5天，然后在第14天和第21天）和干扰素γ（50μg/皮下注射，每周三次）。我们的结果表明，需要进一步研究以确定耐药利什曼原虫物种及其对不同治疗方案的敏感性。
