The treatment of human visceral leishmaniasis, also known as kala azaris, is done, mainly, with Pentavalent Antimonial Compounds, for 20 to 30 days, in order to combat the symptoms of the disease.
Visceral Leishmaniasis is an infection caused in Brazil by the protozoan Leishmania chagasi, which is transmitted by mosquitoes of the species Lutzomyia longipalpis and Lutzomyia cruzi. This disease worsens slowly and can become serious, therefore, in the presence of signs and symptoms that indicate visceral Leishmaniasis, it is important to seek medical attention, for the correct diagnosis and treatment. Learn more about how to identify visceral leishmaniasis.
In addition to the drugs to eliminate the protozoan, treatment must involve the control of common complications of this disease, such as anemia, diarrhea, malnutrition, bleeding and infections due to a drop in immunity, as these are situations that weaken and can put the person's life at risk.
Most used remedies
The main drugs used to treat visceral Leishmaniasis are Pentavalent Antimonial Compounds, such as meglumine antimoniate and sodium stibogluconate, which are the main treatment option, applied in intramuscular or venous doses, for 20 to 30 days. Find out more about how it is used and the price of the most used medicine in the treatment of Leishmaniasis.
In few cases, these drugs can cause side effects, such as arrhythmias, body aches and poor appetite, and are contraindicated in people with kidney or liver failure, in pregnant women in the first two trimesters of pregnancy and in cases that show signs of changes in the electrocardiogram, known as an increase in the QT interval.
Other alternative options in cases of lack or contraindications to these remedies are liposomal Amphotericin B, colloidal dispersion-amphotericin B, Pentamidines and immunomodulators, such as gamma interferon and GM-CSF, in addition to Miltefosina, which is an oral medication that can also be used in the treatment of leishmaniasis.
Care during treatment
Before starting the treatment, some precautions must be observed, among them the evaluation and stabilization of the clinical conditions caused by the disease, such as dressings or transfusions for bleeding control, iron and vitamin replacement or, if necessary, blood transfusion, to help in recovery from anemia, protein and calorie diet to improve malnutrition and use of antibiotics to treat infections.
The treatment can be done at home, as long as the person is able to receive the necessary care in this place and is able to travel to the hospital to receive the medications and for the medical reassessments. In addition, hospitalization should be recommended whenever:
- Severe anemia, with hemoglobin less than 5 g / dL; Severe or prolonged diarrhea; Severe malnutrition; Presence of bleeding; Generalized swelling; Presence of other associated diseases, such as high blood pressure, heart disease, nephropathy or liver disease; Children under 6 months or elderly aged over 65 years; when the disease returns after treatment is finished or there is no response to treatment.
In addition, after the treatment is finished, the person must be followed up by the doctor in consultations after 3, 6 and 12 months and, if he remains stable in the last evaluation, the patient is considered cured.
Signs of improvement
The signs of improvement can already appear after the first week after the beginning of the treatment and are characterized by the reduction of fever, reduction of the swollen belly, weight gain and recovery of the disposition.
Signs of worsening
These signs are more common when treatment is not started quickly and include an increase or recurrence of fever, weight loss, constant weakness, viral and bacterial infections in the body and bleeding.
