Nyakundi P M, Rashid J R, Wasunna K M, Were J B, Muigai R, Kirigi G, Mbugua J
Clinical Research Centre, Kenya Medical Research Institute, Nairobi, Kenya.
East Afr Med J. 1995 Jun;72(6):406-8.
Frequent relapses after treatment for visceral leishmaniasis and apparent parasitological cure is not commonly reported. Seven year old boy who relapsed four times with clinical and parasitological evidence of the disease at each two months follow-up period is presented. He had Leishimania donovani Kenya strain. After treatment, review would be after two months, six months and twelve months periods. Splenic aspirates were routinely done weekly and on the last day of each treatment. The drugs administered for varying periods included intravenous sodium stibogluconate 20 mg/kg daily, P20 in combination with allopurinol 21 mg/kg three times daily, and Pentamidine 4 mg/kg three times weekly and antituberculous drugs. The presence of abundant extra cellular leishmania donovani bodies in the bone marrow and possible pulmonary tuberculosis might have precipitated the frequent relapses. It is not clear which of the drugs effected the cure. It was observed that inspite of prolonged antileishmanial drug administration no side effects were noted.
内脏利什曼病治疗后频繁复发且明显达到寄生虫学治愈的情况并不常见。本文介绍了一名7岁男孩，在每两个月的随访期内复发了4次，每次均有该疾病的临床和寄生虫学证据。他感染的是杜氏利什曼原虫肯尼亚株。治疗后，分别在两个月、六个月和十二个月进行复查。每周常规进行脾脏穿刺抽吸，每次治疗的最后一天也进行。不同时期使用的药物包括静脉注射葡萄糖酸锑钠，每日20mg/kg；P20联合别嘌醇，每日3次，每次21mg/kg；喷他脒，每周3次，每次4mg/kg，以及抗结核药物。骨髓中存在大量杜氏利什曼原虫细胞外体以及可能存在的肺结核可能促使了频繁复发。不清楚哪种药物实现了治愈。观察到尽管长期使用抗利什曼原虫药物，但未发现副作用。
