Relapse of visceral leishmaniasis in HIV infection. Benefit of amphotericin B

Abstract The reference treatment in visceral leishmaniasis is administration of antimonial compounds. Failures have been reported particularly in HIV-positive patients. The authors describe the case of a 40-year-old patient who, after 2 courses of N-methyl-glucamine, relapsed. Bone marrow cultures became negative only after adminstration of amphotericin B (1 mg x kg x d) for 28 days. He is still asymptomatic 18 months after he was cured. Amphotericin B, in case of relapse, seems to be a valuable alternative, until the availability of the liposomal form in our country.