Multiple drugs
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Various toxicities during pregnancy: case report A 25-year-old pregnant woman developed acute kidney injury while receiving treatment with vancomycin and piperacillin/ tazobactum as antibiotic therapy and also developed nausea, chills, rigors and nephrotoxicity while receiving amphotericin B [dosage not stated] for blastomycosis. The woman presented with worsening shortness of breath, chest pain, palpitations, cough and dizziness at 14 weeks of gestation. She suspected to have necrotizing pneumonia. She was hospitalized and started receiving IV vancomycin 1000 mg/day and IV piperacillin/tazobactum [zosyn] 4.5g every 8 hours for 22 days. However, she developed acute kidney injury during therapy. Antibacterials were discontinued. Two weeks later, the woman again presented with hemoptysis. A CT scan showed a mass. She suspected to have angiolipoma. She again started receiving piperacillin/tazobactum. Subsequently, a left upper lobe biopsy showed non-necrotizing granuloma and PCR detected Blastomyces spp. Piperacillin/tazobactum was discontinued. She started receiving IV amphotericin-B for two weeks followed by oral itraconazole. However, after three days of starting amphotericin B, she developed nausea, rigors, chills and nephrotoxicity. On the next day, she was discharged on oral itraconazole 300mg three times daily for 3 days, followed by 300mg twice daily for 6 to 12 months [event outcomes ad pregnancy outcomes not stated]. Wall S. Blastomycosis: Review of a Dimorphic Fungus in Central Pennsylvania. Clinical Microbiology Newsletter 42: 157-161, No. 19, Oct 2020. Available from: URL: 803508104 http://doi.org/10.1016/j.clinmicnews.2020.09.001
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Reactions 17 Oct 2020 No. 1826
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