case_images: PMC4703342_01
case_images: "black rectangle" VL episode; "hatched rectangle" oligosymptomatic VL; BM: bone marrow; PB: peripheral blood; LN: lymph node; BAL: broncho-alveolar lavage; q.3.w: every 3 weeks; mo: month; quantitative PCR (N = negative; 1+ = 0.5-10; 2+ = 11-100; 3+ = 101-1000; 4+ = 1001-100000; 5+ >100000 parasites/ml).. (A)Treatment advice for VL: All patients received L-AmB as first-line treatment; 4 became unresponsive to L-AmB as defined by failure or relapse with positive PCR for Leishmania after at least 2 complete courses (20-60 mg/kg cumulated dose/course). (B) Follow-up of 4 patients non-responders to L-AmB: Cure was defined as a negative smear, culture or PCR on leukoconcentrated blood plus remission of clinical signs and symptoms of VL with no relapse during 6 months. Relapse was defined as positive Leishmania PCR (any sample) associated with recurrence of >=3 of the following markers: fever, splenomegaly, hepatomegaly, anemia, leukopenia, thrombocytopenia, weight loss, asthenia, digestive or cutaneous symptoms suggestive of VL. Patient information and consent were as per FNRCL procedures (http://www.parasitologie.univ-montp1.fr/conseil.htm). Doses of meglumine antimoniate (Glucantime) are expressed in mg of pentavalent antimony/kg.
case_images: pntd.0004304.g001.jpg
case_images: PMC4703342_03_pntd.0004304.g001.jpg
case_images: pntd.0004304.g001
case_images: He received a course of L-AmB followed by maintenance therapy for 5 months (Fig 1B).
case_images: PMC4703342_02
case_images: "black rectangle" VL episode; "hatched rectangle" oligosymptomatic VL; BM: bone marrow; PB: peripheral blood; LN: lymph node; BAL: broncho-alveolar lavage; q.3.w: every 3 weeks; mo: month; quantitative PCR (N = negative; 1+ = 0.5-10; 2+ = 11-100; 3+ = 101-1000; 4+ = 1001-100000; 5+ >100000 parasites/ml).. (A)Treatment advice for VL: All patients received L-AmB as first-line treatment; 4 became unresponsive to L-AmB as defined by failure or relapse with positive PCR for Leishmania after at least 2 complete courses (20-60 mg/kg cumulated dose/course). (B) Follow-up of 4 patients non-responders to L-AmB: Cure was defined as a negative smear, culture or PCR on leukoconcentrated blood plus remission of clinical signs and symptoms of VL with no relapse during 6 months. Relapse was defined as positive Leishmania PCR (any sample) associated with recurrence of >=3 of the following markers: fever, splenomegaly, hepatomegaly, anemia, leukopenia, thrombocytopenia, weight loss, asthenia, digestive or cutaneous symptoms suggestive of VL. Patient information and consent were as per FNRCL procedures (http://www.parasitologie.univ-montp1.fr/conseil.htm). Doses of meglumine antimoniate (Glucantime) are expressed in mg of pentavalent antimony/kg.
case_images: pntd.0004304.g001.jpg
case_images: PMC4703342_03_pntd.0004304.g001.jpg
case_images: pntd.0004304.g001
case_images: He received a course of L-AmB followed by maintenance therapy for 5 months (Fig 1B).
case_images: PMC4703342_03
case_images: "black rectangle" VL episode; "hatched rectangle" oligosymptomatic VL; BM: bone marrow; PB: peripheral blood; LN: lymph node; BAL: broncho-alveolar lavage; q.3.w: every 3 weeks; mo: month; quantitative PCR (N = negative; 1+ = 0.5-10; 2+ = 11-100; 3+ = 101-1000; 4+ = 1001-100000; 5+ >100000 parasites/ml).. (A)Treatment advice for VL: All patients received L-AmB as first-line treatment; 4 became unresponsive to L-AmB as defined by failure or relapse with positive PCR for Leishmania after at least 2 complete courses (20-60 mg/kg cumulated dose/course). (B) Follow-up of 4 patients non-responders to L-AmB: Cure was defined as a negative smear, culture or PCR on leukoconcentrated blood plus remission of clinical signs and symptoms of VL with no relapse during 6 months. Relapse was defined as positive Leishmania PCR (any sample) associated with recurrence of >=3 of the following markers: fever, splenomegaly, hepatomegaly, anemia, leukopenia, thrombocytopenia, weight loss, asthenia, digestive or cutaneous symptoms suggestive of VL. Patient information and consent were as per FNRCL procedures (http://www.parasitologie.univ-montp1.fr/conseil.htm). Doses of meglumine antimoniate (Glucantime) are expressed in mg of pentavalent antimony/kg.
case_images: pntd.0004304.g001.jpg
case_images: PMC4703342_03_pntd.0004304.g001.jpg
case_images: pntd.0004304.g001
case_images: He received a course of L-AmB followed by maintenance therapy for 5 months (Fig 1B).
case_images: PMC4703342_04