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Summary
A case of visceral leishmaniasis of exogenous origin was observed at the U. S. Marine Hospital, Baltimore, Maryland. The diagnosis was definitely established by sternal biopsy. A rapid response to treatment with ethylstibamine occurred, and the patient remained well during 2 months further observation. This patient showed a response to specific therapy which was somewhat more rapid than that usually seen. More prolonged observation following treatment would have been desirable but was not feasible in this case. In the experience of Most and Lavietes (4), while the average interval to relapse following Neostibosan treatment was 5.8 weeks, they found instances of late relapse, and advise observation for 4 to 6 months after treatment. They recommend Neostibosan as the drug of choice in the treatment of the initial infection.
In this case the complement fixation test with L. donovani was positive before treatment. During convalescence, intradermal tests with L. tropica, L. donovani, and L. braziliensis were positive. While the interpretation to be placed on these tests is essentially unknown, the positive reactions are suggestive, and the tests may prove to be of value in investigation of suspected cases of leishmaniasis.