Miltefosine, an Oral Agent, for the Treatment of Indian Visceral Leishmaniasis

Visceral leishmaniasis (kala-azar) is caused by infection of the spleen, liver, bone marrow, and reticuloendothelial system by leishmania that are acquired from sandfly bites. There are an estimated 500,000 cases per year 1 in Asia (primarily India), South America (primarily Brazil), and East Africa (primarily Sudan). There are also several hundred cases per year in the Mediterranean regions of southern Europe in immunocompetent persons and persons with human immunodeficiency virus (HIV) infection, and there are a few cases in the United States that have been acquired elsewhere. Patients with kala-azar present with hepatosplenomegaly and pancytopenia, and the disease is usually fatal . . .