Acute hepatic injury with amphotericin B deoxycholate in an immunocompetent patient

Amphotericin B deoxycholate (AmBd) is rarely used due to its adverse effect profile, which includes nephrotoxicity, infusion-related reactions, and hepatotoxicity. The incidence of hepatotoxicity related to AmBd is 18-23%, but the reports of this adverse effect are mainly in immunocompromised patien...

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Bibliographic Details
Published in:Journal of pharmacology & pharmacotherapeutics 2016-04, Vol.7 (2), p.112-114
Main Authors: Wagner, Jamie, Bell, Allison
Format: Article
Language:English
Subjects:
Amphotericin B
Care and treatment
Case Report
Complications and side effects
Development and progression
Health aspects
Immunocompromised host
Liver diseases
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Summary:Amphotericin B deoxycholate (AmBd) is rarely used due to its adverse effect profile, which includes nephrotoxicity, infusion-related reactions, and hepatotoxicity. The incidence of hepatotoxicity related to AmBd is 18-23%, but the reports of this adverse effect are mainly in immunocompromised patients receiving chemotherapy. We report a case of AmBd-related acute hepatic injury in an immunocompetent male with multiple medical problems. The patient initially had acute hepatic injury likely caused by poor nutritional status and a diagnosis of failure to thrive, but was recovering. He was also diagnosed with bilateral renal fungal mycetomas and received systemic treatment initially with micafungin and then fluconazole after urine cultures returned with the growth of Candida glabrata. Therapy was expanded to systemic AmBd when the fungal balls persisted. The patient subsequently developed hepatic re-injury with 1 dose of AmBd, and the therapy was discontinued. Caution should be exerted when utilizing AmBd in treating patients with previous hepatic injury.
ISSN:0976-500X
0976-5018
DOI:10.4103/0976-500X.184779