Amphotericin B liposomal
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Allergic reaction: 2 case reports Two men with leishmaniasis developed allergic reactions during treatment with amphotericin B liposomal [Ambisome]. A 20-year-old man with post kala-azar dermal leishmaniasis and a history of asthma received amphotericin B liposomal 2.5 mg/kg in 5% dextrose on alternate days [route not stated]. On his fifth dose, he developed flushing, breathlessness, and wheezing. Ambisome was discontinued and he received antiallergic drugs and was given a salbutamol inhaler. One week later, rechallenge provoked chest tightness after a 10cc infusion. A 54-year-old man with mucosal leishmaniasis received amphotericin B liposomal 2.5 mg/kg every other day [route not stated]. During his ninth dose, he developed a rash with vesicles, wheezing, and was gasping for oxygen. Nebulised salbutamol was started. He reported feeling cold, rigors, and chest tightness. Investigations revealed a high eosinophil percentage. Amphotericin B liposomal was withdrawn and the man received antihistamines and IV hydrocortisone. After an uneventful 3-day observation period, he was discharged. Author comment: The first patient "tolerated 4 doses of Ambisome, and unexpectedly, developed symptoms of allergic reaction during the fifth dose." The second patient "tolerated 8 doses of Ambisome, and then developed a serious allergic reaction during the ninth dose accompanied by high eosinophilia suggestive of hypersensitivity to Ambisome. His allergic reaction prompted discontinuation of Ambisome treatment and use of an anti-allergic drug." Mukhtar M, et al. Case report: First report on ambisome-associated allergic reaction in two Sudanese leishmaniasis patients. American Journal of Tropical Medicine and Hygiene 85: 644-645, No. 4, Oct 2011. Available from: URL: http:// 803064731 dx.doi.org/10.4269/ajtmh.2011.10-0511 - Sudan
0114-9954/10/1383-0001/$14.95 © 2010 Adis Data Information BV. All rights reserved
Reactions 7 Jan 2012 No. 1383
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