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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