Treatment of visceral leishmaniasis with intravenous pentamidine and oral fluconazole in an HIV-positive patient with chronic renal failure--a case report and brief review of the literature

Int J Infect Dis. 2010 Jun;14(6):e522-5. doi: 10.1016/j.ijid.2009.06.010. Epub 2009 Sep 1.


We report the case of an HIV-positive patient with visceral leishmaniasis and several relapses after treatment with the two first-line anti-leishmanial drugs, liposomal amphotericin B and miltefosine. End-stage renal failure occurred in 2007 when the patient was on long-term treatment with miltefosine. A relapse of leishmaniasis in 2008 was successfully treated with a novel combination regimen of intravenous pentamidine and oral fluconazole. Secondary prophylaxis with fluconazole monotherapy did not prevent parasitological relapse of leishmaniasis.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • AIDS-Related Opportunistic Infections / complications
  • AIDS-Related Opportunistic Infections / drug therapy*
  • Administration, Oral
  • Antiprotozoal Agents / administration & dosage
  • Antiprotozoal Agents / therapeutic use*
  • Drug Therapy, Combination
  • Fluconazole / administration & dosage
  • Fluconazole / therapeutic use*
  • HIV Seropositivity / complications
  • Humans
  • Injections, Intravenous
  • Kidney Failure, Chronic / complications
  • Leishmania donovani*
  • Leishmaniasis, Visceral / drug therapy*
  • Leishmaniasis, Visceral / etiology
  • Male
  • Middle Aged
  • Pentamidine / administration & dosage
  • Pentamidine / therapeutic use*


  • Antiprotozoal Agents
  • Pentamidine
  • Fluconazole