Recurrent Kala Azar with Recurrent Post-Kala-Azar Anterior Uveitis in an Immuno competent Child: A Case Report

Abstract

We are reporting a case of recurrent Kala azar with recurrent post-Kala-azar anterior uveitis in an 8 year old immune-competent child. Patient presented history of intermittent fever with loss of appetite and lassitude. Diagnosis of Kala azar was made on the basis of clinical examination and bone marrow microscopy. Child was treated with intravenous liposomal Amphotericin B, and was declared cured after 3 weeks. However, after one week of discharge, he presented with both eyes redness and on slit lamp examination bilateral anterior uveitis was detected. Uveitis was treated with topical steroids and cycloplegics. Relapse of Kala azar was noted 5 months after the first attack. He was treated with increased dose of intravenous liposomal Amphotericin B. After completion of treatment, bilateral anterior uveitis was noted. This was more severe than first attack, associated with fibrinous exudates in the left eye. Uveitis was successfully treated with topical steroids and cycloplegics. He presented with second relapse of Kala azar 7 months after the second attack and this time he was treated with intravenous liposomal Amphotericin B along with oral Miltefosine. On the 4th day of treatment, anterior chamber cells were noted bilaterally and this inflammation was controlled with topical steroids and cycloplegics.