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Table 2 Investigations, treatment and outcome in seven immunosuppressed patients with visceral leishmaniasis, 2009–2018, Norway

From: Imported visceral leishmaniasis and immunosuppression in seven Norwegian patients

Case no Sex Age Microscopy (site) Serology PCR (site) Sequencing Hemoglobin (13.4–17.0 g/dl) Leukocyte (3.5–10.0 109/L) Thrombocytes (145–390 109/L) Treatment – total cumulative doses of AmB/L-AmB Outcome
Patient 1 M 66 Positive (skin ulcer) Positive Positive (bone marrow) L.infantum 8.8 1.4 165 2350 mg(26 mg/kg) Cured
Patient 2 M 78 Positive (spleen) Positive NA NA 9.3 1.0 20 1740 mga(23 mg/kg) Cured
Patient 3 M 79 Positive (bone marrow) Positive NA NA 8.6 1.0 15 1800 mg(20 mg/kg) Cured. Relapse after 17 months, recovery after re-treatment L-AmB 2000 mg. Died two years later of unknown cause
Patient 4 M 57 Positive (spleen aspirate) Positive Positive (blood) L.infantum 7.6 0.9 105 1400 mg21 mg/kg Cured
Patient 5 M 41 Positive (bone marrow) NA Positive (blood) L.infantum 8.5 1.8 95 2040 mg (29 mg/kg) Cured. Relapse after 3 months, recovery after re-treatment L-AmB 1400 mg. FU = 19 months
Patient 6 M 83 Positive (spleen aspirate) Positive Positive (spleen and blood) L.infantum 10.0 1.6 110 3300 mg (37 mg/kg) Cured
Patient 7 F 46 No parasites seen (spleen aspirate) NA Positive (spleen) L.infantum 9.8 1.3 61 1760 mg (21 mg/kg) Cured
  1. Reference values for blood tests are given in brackets. Abbreviations: M male, F female, VL visceral leishmaniasis, RA rheumatoid arthritis, CL cutan leishmaniasis, MTX methotrexate, NA not analyzed, PCR polymerase chain reaction, FU time of follow-up, dl deciliters, L liters, BM bone marrow, AmB amphotericin B, L-AmB liposomal amphotericin B. aIn Thailand: AmB 340 mg + In Norway: 1400 mg L-AmB