Acute Lung Injury with Amphotericin Infusion in a Patient with Invasive Mucormycosis

Title:Acute Lung Injury with Amphotericin Infusion in a Patient with Invasive Mucormycosis

Volume: 22 Issue: 8

Author(s): Swapnil Tripathi, Durga Shankar Meena*, Deepak Kumar and Gopal Krishana Bohra

Affiliation:

• Department of Medicine, All India Institute of Medical Sciences, Jodhpur 342005, India

Keywords: Amphotericin, antifungal, adverse drug reaction, infusion reaction, dyspnea, pulmonary infiltrates.

Abstract:

Background: Amphotericin B is a pivotal drug for the management of invasive fungal infections. However, it has a significant toxicity profile with acute infusion reactions like fever, chills, vomiting, anaphylaxis, and nephrotoxicity in patients with long-term use. Pulmonary reactions mimicking acute pulmonary edema are unusual with amphotericin.

Case Description: We report a case of a 51-year-old male diagnosed with rhinomaxillary mucormycosis, who developed acute onset breathlessness, bilateral diffuse pulmonary infiltrates after amphotericin infusion. The patient recovered spontaneously within a few hours after the cessation of amphotericin, which was parallel with the normalization of Chest X-ray. Furthermore, the Naranjo adverse reaction probability score was 9, which established a definite causal relation between drug use and adverse event.

Conclusion: Clinicians should be aware of acute lung injury in patients treated with amphotericin infusion. In cases with no alternative available, a slow infusion of amphotericin with close monitoring is required to prevent life-threatening pulmonary reactions.

Cite this article as:

Tripathi Swapnil, Meena Shankar Durga*, Kumar Deepak and Bohra Krishana Gopal, Acute Lung Injury with Amphotericin Infusion in a Patient with Invasive Mucormycosis, Infectious Disorders - Drug Targets 2022; 22 (8) : e190422203795 . https://dx.doi.org/10.2174/1871526522666220419132741