Table 3

Outcome of nine patients who relapsed

Year of
presentation
Remarks
Cured with Pentostam alone
1980Relapsed twice, and on both occasions treated with Pentostam
1981Relapsed five weeks after stopping treatment—afebrile but had splenomegaly. Responded to second course of Pentostam
1983Relapsed five weeks after stopping treatment. Responded to second course of Pentostam—this time for three weeks
1984Relapsed one week after stopping treatment. Responded to second course of Pentostam—this time for four weeks
Required other drugs in addition to Pentostam
1981Slow response to treatment. Bone marrow at two weeks showed LDBs. Pentostam increased to 25 mg/kg/day, with poor response. LDBs still present in bone marrow, so treated with pentamidine, successfully
1981Relapsed six times. First five times treated with Pentostam. Last relapse treated with pentamidine and cotrimoxazole
1987Relapsed four weeks after stopping treatment, and presented in diabetic ketoacidosis. Given Pentostam for three weeks but relapsed after six weeks. Given metronidazole and rifampicin for four weeks but relapsed after eight weeks. Given Pentostam for 12 weeks but remained unwell and LDBs were detected in bone marrow at one year. Successfully treated with aminosidine
1989Relapsed at 12 weeks and treated with a combination of Pentostam and pentamidine
1990No response to eight weeks of Pentostam. Responded to intramuscular pentamidine, a total of 15 doses on alternate days