Amphotericin-B liposomal
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Pancytopenia: case report A 38-year-old man developed pancytopenia during treatment with amphotericin-B liposomal for rhino-orbital mucormycosis. The man, who had uncontrolled diabetes mellitus (noncompliant on medication), presented to an outside hospital with rightsided cheek swelling, right-sided sinus fullness and headache for 10 days. Examination revealed necrotic lesions in the oral cavity with a large palatal perforation. After further investigations, he was diagnosed with rhino-orbital mucormycosis. He was started receiving amphotericin-B liposomal [liposomal amphotericin-B; route not stated] 5 mg/kg, and underwent an extensive debridement. However, during the treatment, he developed worsening pancytopenia secondary to amphotericin-B liposomal [duration of treatment to reaction onset not stated]. The man’s amphotericin-B liposomal therapy was discontinued. After discontinuation of amphotericin-B liposomal, his pancytopenia improved. The man was restarted on amphotericin-B liposomal at a lower dose of 3 mg/kg, but pancytopenia reoccurred. After the recovery of pancytopenia, amphotericin-B liposomal was reintroduced at even lower dose of 1 mg/kg, which was unsuccessful. Due to unavailability of IV isavuconazole or posaconazole, he was started on oral posaconazole, which he received for 6 months. After 6 months, it was discontinued. Gupta N, et al. Amphotericin-induced pancytopenia in a patient with rhino-orbital mucormycosis. Postgraduate Medical Journal 96: 572, No. 1139, Sep 2020. Available from: 803516305 URL: http://doi.org/10.1136/postgradmedj-2019-137378
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Reactions 21 Nov 2020 No. 1831
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