TREATMENT OF VISCERAL LEISHMANIASIS IN A PATIENT WITH AIDS WITH ANTIMONY AND GAMMA-INTERFERON - REMISSION AND PREVENTION OF RELAPSE BY MAINTENANCE THERAPY WITH WEEKLY PENTAMIDINE

A 41-year-old AIDS patient with fever, nightly perspiration, diarrhoea , anaemia and leukopenia was diagnosed as having visceral leishmaniasi s (VL). After 8 weeks of antimony treatment combined with gamma-interf eron, given in 2 courses of 3 and 5 weeks, 12 weeks apart, the bone ma rrow revealed no parasites by microscopy and culture. Parasitic DNA co uld still be demonstrated by polymerase chain reaction. Weekly intrave nous pentamidine maintenance therapy seemed to prevent relapses. Over time the patient was treated for disseminated M. avium infection, CMV retinitis, porphyria cutanea tarda and renal tubular acidosis. Ultimat ely he succumbed, 2.5 years after the diagnosis of VL and 4.5 years af ter the diagnosis of AIDS was established.