Volume 84, Issue 4
  • ISSN: 0002-9637
  • E-ISSN: 1476-1645



AmBisome (liposomal amphotericin B) is used for prophylaxis and treatment of fungal infections, treatment of visceral leishmaniasis, and more recently, treatment of cutaneous leishmaniasis. Although the package insert cites neurologic toxicities in up to 20% of cases, review of the literature did not reveal any specific cases describing this side effect, particularly in a patient without comorbidities. We describe a healthy 38-year-old male treated with liposomal amphotericin B for cutaneous leishmaniasis acquired during military duties in Iraq. Shortly after completion of his treatment course, he reported memory difficulties and confusion. Further evaluation revealed no other source, and his cognitive issues were attributed to liposomal amphotericin B toxicity. These issues resolved over a few weeks, which is consistent with data about the drug's tissue penetration and metabolism available in the literature. This is a potential side effect of liposomal amphotericin B that can be observed in otherwise healthy patients.


Article metrics loading...

The graphs shown below represent data from March 2017
Loading full text...

Full text loading...



  1. Reithinger R, Dujardin J, Louzir H, Pirmez C, Alexander B, Brooker S, , 2007. Cutaneous leishmaniasis. Lancet Infect Dis 7: 581596.[Crossref] [Google Scholar]
  2. Paradisi A, Capizzi R, Zampetti A, Proietti I, De Simone C, Feliciani C, Amerio PL, , 2005. Atypical multifocal cutaneous leishmaniasis in an immunocompetent patient treated by liposomal amphotericin. J Infect 51: e261e264.[Crossref] [Google Scholar]
  3. Brown M, Noursadeghi M, Boyle J, Davidson RN, , 2005. Successful liposomal amphotericin B treatment of Leishmania braziliensis cutaneous leishmaniasis. Br J Dermatol 153: 203205.[Crossref] [Google Scholar]
  4. Amato VS, Rabello A, Rotondo-Silva A, Kono A, Maldonado TPH, Alves IC, Floeter-Winter LM, Neto VA, Shikanai-Yasuda MA, , 2004. Successful treatment of cutaneous leishmaniasis with lipid formulations of amphotericin B in two immunocompromised patients. Acta Trop 92: 127132.[Crossref] [Google Scholar]
  5. Solomon M, Baum S, Barzilai A, Scope A, Trau H, Schwartz E, , 2007. Liposomal amphotericin B in comparison to sodium stibogluconate for cutaneous infection due to Leishmania braziliensis . J Am Acad Dermatol 56: 612616.[Crossref] [Google Scholar]
  6. Del Rosal T, Artigao FB, Garcia Miguel MJ, de Lucas R, del Castillo F, , 2009. Successful treatment of childhood cutaneous leishmaniasis with liposomal amphotericin B: report of two cases. J Trop Pediatr 56: 122124.[Crossref] [Google Scholar]
  7. Wortmann G, Zapor M, Ressner R, Fraser S, Hartzell J, Pierson J, Weintrob A, Magill A, , 2010. Liposomal amphotericin B for treatment of cutaneous leishmaniasis. Am J Trop Med Hyg 83: 10281033.[Crossref] [Google Scholar]
  8. Meyerhoff A, , 1999. U.S. Food and Drug Administration approval of AmBisome (Liposomal Amphotericin B) for treatment of visceral leishmaniasis. Clin Infect Dis 28: 4248.[Crossref] [Google Scholar]
  9. Haber RW, Joseph M, , 1962. Neurological manifestations after amphotericin B therapy. BMJ 1: 230231.[Crossref] [Google Scholar]
  10. Weddington WW, , 1982. Delirium and depression associated with amphotericin B. Psychosomatics 23: 10761078.[Crossref] [Google Scholar]
  11. Clemons KV, Sobel RA, Williams PL, Pappagianis D, Stevens DA, , 2002. Efficacy of intravenous liposomal amphotericin B (AmBisome) against coccidioidal meningitis in rabbits. Antimicrob Agents Chemother 46: 24202426.[Crossref] [Google Scholar]
  12. Takemoto K, Yamamoto Y, Ueda Y, , 2006. Influence of the progression of cryptococcal meningitis on brain Penetration and efficacy of AmBisome in a murine model. Chemotherapy 52: 271278.[Crossref] [Google Scholar]
  13. Vogelsinger H, Weiler S, Djanani A, Kountchev J, Bellmann-Weiler R, Wiedermann CJ, Bellmann R, , 2006. Amphotericin B tissue distribution in autopsy material after treatment with liposomal amphotericin B and amphotericin B colloidal dispersion. J Antimicrob Chemother 57: 11531160.[Crossref] [Google Scholar]
  14. Coukell AJ, Brogden RN, , 1998. Liposomal amphotericin B therapeutic use in the management of fungal infections and visceral leishmaniasis. Drugs 55: 585612.[Crossref] [Google Scholar]
  15. Smith PJ, Olson JA, Constable D, Schwartz J, Proffitt RT, Adler-Moore JP, , 2007. Effects of dosing regimen on accumulation, retention and prophylactic efficacy of liposomal amphotericin B. J Antimicrob Chemother 59: 941951.[Crossref] [Google Scholar]
  16. Bekersky I, Boswell GW, Hiles R, Fielding RM, Buell D, Walsh TJ, , 2000. Safety, toxicokinetic and tissue distribution of long-term intravenous liposomal amphotericin B (AmBisome): a 91-day study in rats. Pharm Res 17: 14941502.[Crossref] [Google Scholar]
  17. Wingard JR, White MH, Anaissie E, Raffalli J, Goodman J, Arrieta A, , L Amph/ABLC Collaborative Study Group, 2000. A randomized, double-blind comparative trial evaluating the safety of the liposomal amphotericin B versus amphotericin B lipid complex in the empirical treatment of febrile neutropenia. Clin Infect Dis 31: 11551163.[Crossref] [Google Scholar]
  18. Larabi M, Yardley V, Loiseau PM, Appel M, Legrand P, Gulik A, Bories C, Croft SL, Barratt G, , 2003. Toxicity and antileishmanial activity of a new stable lipid suspension of amphotericin B. Antimicrob Agents Chemother 47: 37743779.[Crossref] [Google Scholar]
  19. Olliaro PL, Guerin PJ, Gerstl S, Haaskjold AA, Rottigen J, Sundar S, , 2005. Treatment options for visceral leishmaniasis: a systematic review of clinical studies done in India, 1980–2004. Lancet Infect Dis 5: 763774.[Crossref] [Google Scholar]
  • Received : 23 Nov 2010
  • Accepted : 26 Dec 2010
  • Published online : 05 Apr 2011

Most Cited This Month

This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error