A 25-year-old student returning from a trip to Bihar (India) develops fever, weight loss, and massive splenomegaly. Bone marrow aspiration shows numerous amastigotes (Leishman-Donovan bodies) within macrophages. The drug of choice in India for visceral leishmaniasis is:

• A Single-dose liposomal amphotericin B 10 mg/kg IV ✓
• B Sodium stibogluconate (SSG) 20 mg/kg/day IM for 30 days
• C Amphotericin B deoxycholate 0.75–1 mg/kg IV on alternate days for 15 doses
• D Miltefosine 2.5 mg/kg/day oral for 28 days

Explanation

In India (Bihar), where SSG (pentavalent antimonial) resistance exceeds 60%, single-dose liposomal amphotericin B (AmBisome) 10 mg/kg is now the first-line treatment recommended by the National Kala-azar Elimination Programme (NKEP) and WHO/NVBDCP — it achieves >97% cure rates with a single infusion and is well-tolerated. Miltefosine (28 days oral) was widely used but increasing resistance and compliance issues have reduced its preference as first-line. Amphotericin B deoxycholate is effective but more nephrotoxic than liposomal formulation.

Reference: Ananthanarayan & Paniker's Textbook of Microbiology, 11th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.