DRESS Syndrome Associated with Liposomal Amphotericin-B in a Kidney Transplant Patient: A case report

Introduction: Liposomal amphotericin B is a widely used broad-spectrum antifungal drug. It was developed to reduce nephrotoxicity and maximize the therapeutic utility of amphotericin B in the treatment of invasive fungal infections. Drug Rash with Eosinophilia and Systemic Symptoms (DRESS) syndrome is a severe drug-induced hypersensitivity syndrome commonly associated with aromatic antiepileptic drugs. Liposomal amphotericin-B was associated with DRESS syndrome in only one case. Case Report: We report an exceptional case of possible DRESS syndrome associated with Liposomal amphotericin B in a 31-year-old male, renal transplant recipient. Seventeen days after starting Liposomal amphotericin B for visceral leishmaniosis, he developed a skin rash, with elevated liver tests. Liposomal amphotericin B was discontinued. A favourable outcome was slowly observed in one month. Results and Conclusion: This case was scored two (possible case) based on the criteria adopted by the European group RegiSCAR. The Naranjo score for Liposomal amphotericin B was four (possible).

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Drug-induced hypersensitivity syndrome by liposomal amphotericin-B: a case report

BMC Research Notes ◽

10.1186/s13104-015-1486-0 ◽

2015 ◽

Vol 8 (1) ◽

Cited By ~ 3

Author(s):

Mao Hagihara ◽

Yuka Yamagishi ◽

Jun Hirai ◽

Yusuke Koizumi ◽

Hideo Kato ◽

...

Keyword(s):

Case Report ◽

Amphotericin B ◽

Liposomal Amphotericin ◽

Hypersensitivity Syndrome ◽

Liposomal Amphotericin B ◽

Drug Induced

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Disseminated fusariosis in a pediatric patient with acute lymphoblastic leukemia and prolonged fever - a case report

Medicinski pregled ◽

10.2298/mpns1810316k ◽

2018 ◽

Vol 71 (9-10) ◽

pp. 314-318

Author(s):

Natasa Kacanski ◽

Branislava Radisic ◽

Jovanka Kolarovic

Keyword(s):

Case Report ◽

Acute Lymphoblastic Leukemia ◽

Amphotericin B ◽

Liposomal Amphotericin ◽

Lymphoblastic Leukemia ◽

Fusarium Species ◽

Water System ◽

Liposomal Amphotericin B ◽

Fusarium Infection ◽

Days Of Therapy

Introduction. Infections caused by fungi of Fusarium species occur in immunocompromised individuals as disseminated diseases. Case Report. This case report presents a 5-year-old boy with acute lymphoblastic leukemia who developed a disseminated fusarium infection during reinduction chemotherapy. Fever was the main symptom and it lasted for 15 weeks. Refractory fever despite broad-spectrum antibiotics, as well as nausea, myalgia, pulmonary symptoms with detection of pulmonary infiltrates, liver and spleen involvement indicated an invasive fungal infection. The patient received fluconazole, voriconazole, liposomal amphotericin B and caspofungin. Since high temperature was persistent, diagnostic laparoscopy of the abdomen was done. Scattered lesions, up to 2 mm in diameter, were observed macroscopically on the surface of the liver and spleen. The liver culture was positive for Acinetobacter and Fusarium species. After 38 days of therapy with liposomal amphotericin B and 3 days of ciprofloxacin, the patient became afebrile. Itraconazole (according to the antimycogram) was continued during maintenance therapy. Abdominal ultrasound was completely normal after 5 months of treatment with itraconazole. This boy was our first patient with a disseminated fusarium infection. At that time, Fusarium was detected in the hospital water system and in hospital air samples. Conclusion. A timely diagnosis of invasive fungal diseases in children is a big challenge. Over the past decade, there has been an increase in survival rate of patients with invasive fusariosis due to much more common use of voriconazole or combined antifungal therapy.

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Efficacy of Early Administration of Liposomal Amphotericin B in Patients with Septic Shock: A Nationwide Observational Study

10.21203/rs.3.rs-122288/v1 ◽

2020 ◽

Author(s):

Masato Tashiro ◽

Takahiro Takazono ◽

Yuki Ota ◽

Tomotaro Wakamura ◽

Akinori Takahashi ◽

...

Keyword(s):

Septic Shock ◽

Amphotericin B ◽

Liposomal Amphotericin ◽

Fungal Infections ◽

Survival Rates ◽

Liposomal Amphotericin B ◽

National Database ◽

Shock Onset ◽

Significant Difference ◽

Nationwide Observational Study

Abstract To determine the most suitable time to initiate liposomal amphotericin B (L-AMB) treatment in patients with invasive fungal infections, patients with septic shock treated with L-AMB were identified from the Japanese Diagnosis Procedure Combination national database to determine their survival rates following septic shock onset, mortality during shock, and shock cessation period. We identified 141 patients administered L-AMB: 60 patients received treatment on the day of septic shock onset (early L-AMB group), whereas 81 patients received treatment after the onset (delayed L-AMB group). Survival rates after septic shock onset were higher in the early L-AMB group than in the delayed L-AMB group (4 weeks: 68.4% vs 57.9%, P=0.197; 6 weeks: 62.2% vs 44.5%, P=0.061; 12 weeks: 43.4% vs 35.0%, P=0.168, respectively). Mortality during septic shock was significantly lower in the early L-AMB group than in the delayed L-AMB group (13% vs 42%, P<0.001), with a significant difference confirmed after adjusting for confounding factors (odds ratio: 0.240, 95% confidence interval: 0.096-0.601, P=0.002). Septic shock cessation period was shorter in the early L-AMB group than in the delayed L-AMB group (7.0±7.0 days vs 16.5±15.4 days, P<0.001). L-AMB administration at septic shock onset could be associated with early shock cessation and decreased mortality.

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