A HIV coinfected patient with BV.Leiahmaniasis is given Amphotericin B has had seizures which is now rare after giving him the medicine again after a gap of about ten days on completion of 14 days But still suffers from severe headache,Vision issues, hearing issues,nausea and vomiting,loss of appetite.But ART is with

Hello Mr Thomte,

Thank you for reaching out. Based on the details shared, the patient is dealing with HIV coinfection and visceral leishmaniasis, for which Amphotericin B is being administered. The reported symptoms—seizures (rare), severe headache, vision and hearing issues, nausea, vomiting, and loss of appetite—warrant a detailed assessment, as these could be related to the underlying conditions, treatment side effects, or other complications.

Immediate Steps and Suggested Treatment Options

1. Clinical Assessment and Consultation

   • Neurological Examination and consultation with Neurologist: To assess the cause of seizures, headaches, and vision/hearing issues.
   • Fundoscopy and Imaging: If headaches and vision changes persist, evaluate for papilledema or intracranial pressure.
   • Infectious Disease Specialist: To optimize HIV and leishmaniasis treatment and manage co-infections.
     
     

2. Laboratory Tests
   

   • Monitor kidney function (serum creatinine, urea).
   • Check electrolytes (potassium, magnesium, calcium).
   • Perform a complete blood count and liver function tests.
     
     
3. Medication Adjustment
   
   
   • Reassess the dosing schedule of Amphotericin B.
   • Consider anti-emetics for nausea/vomiting and appropriate medications for headaches and appetite stimulation.