A patient from Assam presents with fever, splenomegaly, anaemia and pancytopenia. Bone marrow aspirate shows intracellular amastigotes within macrophages with a distinct kinetoplast (bar-like structure). The drug of choice is:
- A Sodium stibogluconate
- B Liposomal amphotericin B ✓
- C Miltefosine
- D Paromomycin
Correct answer: B. Liposomal amphotericin B
Explanation
Visceral leishmaniasis (kala-azar) caused by Leishmania donovani is diagnosed by demonstrating LD bodies (amastigotes) in bone marrow, spleen, or liver. In India, the current first-line treatment per WHO and national guidelines is single-dose liposomal amphotericin B due to high efficacy and a single-infusion regimen. Miltefosine is oral and second-line in India; sodium stibogluconate (pentavalent antimony) is no longer first-line in India due to high resistance in Bihar/Assam endemic zones.
Reference: Ananthanarayan & Paniker's Textbook of Microbiology, 11th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
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