Expansion of Visceral Leishmaniasis to the Western Hilly Part of Nepal

Basu Dev Pandey Sukraraj Tropical and Infectious Diseases Hospital, Kathmandu, Nepal; Everest International Clinic and Research Center, Kathmandu, Nepal; Department of Protozoology, Institute of Tropical Medicine (NEKKEN) and the Global Center of Excellence Program, Nagasaki University, Nagasaki, Japan; Department of Immunogenetics, Institute of Tropical Medicine (NEKKEN) and the Global Center of Excellence Program, Nagasaki University, Nagasaki, Japan

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Sher Bahadur Pun Sukraraj Tropical and Infectious Diseases Hospital, Kathmandu, Nepal; Everest International Clinic and Research Center, Kathmandu, Nepal; Department of Protozoology, Institute of Tropical Medicine (NEKKEN) and the Global Center of Excellence Program, Nagasaki University, Nagasaki, Japan; Department of Immunogenetics, Institute of Tropical Medicine (NEKKEN) and the Global Center of Excellence Program, Nagasaki University, Nagasaki, Japan

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Osamu Kaneko Sukraraj Tropical and Infectious Diseases Hospital, Kathmandu, Nepal; Everest International Clinic and Research Center, Kathmandu, Nepal; Department of Protozoology, Institute of Tropical Medicine (NEKKEN) and the Global Center of Excellence Program, Nagasaki University, Nagasaki, Japan; Department of Immunogenetics, Institute of Tropical Medicine (NEKKEN) and the Global Center of Excellence Program, Nagasaki University, Nagasaki, Japan

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Kishor Pandey Sukraraj Tropical and Infectious Diseases Hospital, Kathmandu, Nepal; Everest International Clinic and Research Center, Kathmandu, Nepal; Department of Protozoology, Institute of Tropical Medicine (NEKKEN) and the Global Center of Excellence Program, Nagasaki University, Nagasaki, Japan; Department of Immunogenetics, Institute of Tropical Medicine (NEKKEN) and the Global Center of Excellence Program, Nagasaki University, Nagasaki, Japan

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Kenji Hirayama Sukraraj Tropical and Infectious Diseases Hospital, Kathmandu, Nepal; Everest International Clinic and Research Center, Kathmandu, Nepal; Department of Protozoology, Institute of Tropical Medicine (NEKKEN) and the Global Center of Excellence Program, Nagasaki University, Nagasaki, Japan; Department of Immunogenetics, Institute of Tropical Medicine (NEKKEN) and the Global Center of Excellence Program, Nagasaki University, Nagasaki, Japan

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DOI:
https://doi.org/10.4269/ajtmh.2011.10-0291
Volume/Issue:
Volume 84: Issue 1
Page(s):
107–108
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We report the first case of visceral leishmaniasis (VL) from the non-endemic western hilly region of Nepal. The patient presented with a history of high-grade fever, abdominal distension, anemia, and weight loss. The case was confirmed as VL by microscopical detection of the Leishmania species amastigote in bone marrow aspiration and by a positive result for the rK39 test. The patient was treated with 0.5–1.0 mg/kg of Amphotericin B for 14 days (total of 405 mg), and amastigotes were negative on discharge. Five months later, this patient again developed fever, abdominal distension, and anemia. Clinical and hematological examinations suggested a relapse of VL. The patient was treated with 1 mg/kg of Amphotericin B for 18 days (total of 515 mg) and was clinically improved on discharge.

Author Notes

*Address correspondence to Basu Dev Pandey, Sukraraj Tropical and Infectious Diseases Hospital and Everest International Clinic and Research Center, Teku Road, Kathmandu, Nepal 9045. E-mail: basupandey@wlink.com.np

Financial support: This study was supported in part by Grants-in-Aid from Ministry of Education, Culture, Sports, Science and Technology (MEXT), the Global Center of Excellence (COE) Program at Nagasaki University (to O.K. and K.H.), and the National Bio-Resource Project (NBRP) of MEXT, Japan (to K.H.).

Authors' addresses: Basu Dev Pandey and Sher Bahadur Pun, Sukraraj Tropical and Infectious Diseases Hospital and Everest International Clinic and Research Center, Kathmandu, Nepal, E-mails: basupandey@wlink.com.np and drsherbdr@yahoo.com. Osamu Kaneko, Department of Protozoology, Institute of Tropical Medicine (NEKKEN) and the Global Center of Excellence Program, Nagasaki University, Nagasaki, Japan, E-mail: okaneko@nagasaki-u.ac.jp. Kishor Pandey, Everest International Clinic and Research Center, Kathmandu, Nepal, E-mail: pandey_kishor@hotmail.com. Kenji Hirayama, Department of Immunogenetics, Institute of Tropical Medicine (NEKKEN) and the Global Center of Excellence Program, Nagasaki University, Nagasaki, Japan, E-mail: hiraken@nagasaki-u.ac.jp.

Copyright:
©The American Society of Tropical Medicine and Hygiene 2011
Received:
21 May 2010
|
Accepted:
05 Sep 2010
|
Published Online:
05 Jan 2011
Cover The American Journal of Tropical Medicine and Hygiene
The American Journal of Tropical Medicine and Hygiene
Print ISSN:
0002-9637
Online ISSN:
1476-1645
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