Migration of Leishmania donovani amastigotes in the cerebrospinal fluid

A 10-year-old boy had been suffering from kala-azar (visceral leishmaniasis) for two and a half years. He failed to respond to all known anti-leishmanial treatment regimens. Even the drastic step of splenectomy failed to cure him. In November 1991, he presented with symptoms of meningitis. A diagnostic lumbar puncture revealed leishmanial amastigotes in his cerebrospinal fluid. The patient was finally cured with a course of amphotericin B, a drug known to cross the blood-brain barrier.