Discussion exercises

5-7^th days: fever subsides

~7^th day: WBC count decreases

~14^th day: spleen size starts to decrease, WBC count and Hbg starts to increase

~28^th day: spleen regresses fully or becomes tip; Hgb reaches around 10g/dl

Leishmanin skin test (LST) assesses the cell mediated immunity. VL occurs when the cell mediated immunity fails to contain the infection. Thus, LST is negative in VL patients. It becomes positive long after treatment is completed, ~60% by one year after treatment.

Reconstitute the 50mg AmBisome with 12 ml. Remember that each ml will have 4mg of AmBisome. This patient will need 52kg X 5mg/Kg = 260mg. Dividing 260mg to 4mg/ml = 65ml. This means 5 vials of AmBisome each with 12ml and 5ml from the sixth vial. That means six vials will be needed.