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Indian J Med Microbiol. 2012 Apr-Jun;30(2):227-9. doi: 10.4103/0255-0857.96703.

Relapse of kala-azar after use of multiple drugs: a case report and brief review of literature.

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Everest International Clinic and Research Center, Kathmandu, Nepal.


We present a case of kala-azar infection that recurred in a patient after completion of the standard treatment course of miltefosine, amphotericin B-deoxycholate (short course), and amphotericin B lipid formulations. The patient was cured after continuous amphotericin B-deoxycholate administration for 4 weeks. This is a unique case of relapse following the use of three important drugs. Although amphotericin B-deoxycholate is a second line drug in Nepal, it has shown a satisfactory clinical response with continuous treatment for 4 weeks. Therefore, an extended course of amphotericin B-deoxycholate may be beneficial in patients with resistance to the standard short course and other anti-leishmania drugs.

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