PROBLEMS IN THE TREATMENT OF KALA-AZAR - CASE-REPORT

Frequent relapses after treatment for visceral leishmaniasis and appar ent 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 L eishimania donovani Kenya strain, After treatment, review would be aft er 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 st ibogluconate 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 leishma nia donovani bodies in the bone marrow and possible pulmonary tubercul osis might have precipitated the frequent relapses. It is not clear wh ich of the drugs effected the cure, It was observed that inspite of pr olonged antileishmanial drug administration no side effects were noted .