A Successful Treatment of a Child with Clinical Relapse of Visceral Leishmaniasis Complicated with AH1N1

Introduction Visceral leishmaniasis is associated with poor sanitary conditions in Albania as suggested by clinical relapses and frequency of comorbidities. New lipid formulations are costly and have only been used as the first choice in cases of clinical relapses or resistance from meglumine antimoniate. Case presentation This is a retrospective case report of a 14 month old child diagnosed with visceral leishmaniasis and treated with meglumine antimoniate for 28 days. Six months later he was readmitted to the hospital for clinical relapse of VL. His status was complicated by interstitial bronchopneumonia and influenza AH1N1. In this situation we re-treated the patient using intravenous liposomal amphotericin B ( L-AmB) with dosing 3mg/kg weight in days 15, 14 and 21. Due to the influenza AH1N1 complication, the child was also treated with oseltamivir for 5 days. L-AmB and oseltamivir were well tolerated by the child, no side effects were seen. Following treatment with L-AmB, bone-marrow aspirate resulted negative for VL and laboratory exam values were normal. Conclusion L-AmB is considered the treatment of choice in clinical relapses of visceral leishmaniasis first treated with antimone based preparations.