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1.
Reithinger R, Dujardin J, Louzir H, Pirmez C, Alexander B, Brooker S, 2007. Cutaneous leishmaniasis. Lancet Infect Dis 7: 581–596.
-
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: e261–e264.
-
3.
Brown M, Noursadeghi M, Boyle J, Davidson RN, 2005. Successful liposomal amphotericin B treatment of Leishmania braziliensis cutaneous leishmaniasis. Br J Dermatol 153: 203–205.
-
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: 127–132.
-
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: 612–616.
-
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: 122–124.
-
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: 1028–1033.
-
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: 42–48.
-
9.
Haber RW, Joseph M, 1962. Neurological manifestations after amphotericin B therapy. BMJ 1: 230–231.
-
10.
Weddington WW, 1982. Delirium and depression associated with amphotericin B. Psychosomatics 23: 1076–1078.
-
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: 2420–2426.
-
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: 271–278.
-
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: 1153–1160.
-
14.
Coukell AJ, Brogden RN, 1998. Liposomal amphotericin B therapeutic use in the management of fungal infections and visceral leishmaniasis. Drugs 55: 585–612.
-
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: 941–951.
-
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: 1494–1502.
-
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: 1155–1163.
-
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: 3774–3779.
-
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: 763–774.
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| Abstract Views | 248 | 184 | 15 |
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Central Nervous System Toxicity Associated with Liposomal Amphotericin B Therapy for Cutaneous Leishmaniasis
Jessie S. Glasser
Jessie S. Glasser
Brooke Army Medical Center, Fort Sam Houston, Texas; Uniformed Services University of the Health Sciences, Bethesda, Maryland; University of Texas Health Science Center at San Antonio, San Antonio, Texas
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Clinton K. Murray
Clinton K. Murray
Brooke Army Medical Center, Fort Sam Houston, Texas; Uniformed Services University of the Health Sciences, Bethesda, Maryland; University of Texas Health Science Center at San Antonio, San Antonio, Texas
Search for other papers by Clinton K. Murray in
Current site
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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.
Author Notes
Authors' addresses: Jessie S. Glasser and Clinton K. Murray, US Infectious Disease Service, Brooke Army Medical Center, Fort Sam Houston, TX, E-mails: Jessie.glasser@amedd.army.mil and Clinton.Murray@amedd.army.mil.
ProCite
RefWorks
Reference Manager
BibTeX
Zotero
EndNote
-
1.
Reithinger R, Dujardin J, Louzir H, Pirmez C, Alexander B, Brooker S, 2007. Cutaneous leishmaniasis. Lancet Infect Dis 7: 581–596.
-
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: e261–e264.
-
3.
Brown M, Noursadeghi M, Boyle J, Davidson RN, 2005. Successful liposomal amphotericin B treatment of Leishmania braziliensis cutaneous leishmaniasis. Br J Dermatol 153: 203–205.
-
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: 127–132.
-
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: 612–616.
-
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: 122–124.
-
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: 1028–1033.
-
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: 42–48.
-
9.
Haber RW, Joseph M, 1962. Neurological manifestations after amphotericin B therapy. BMJ 1: 230–231.
-
10.
Weddington WW, 1982. Delirium and depression associated with amphotericin B. Psychosomatics 23: 1076–1078.
-
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: 2420–2426.
-
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: 271–278.
-
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: 1153–1160.
-
14.
Coukell AJ, Brogden RN, 1998. Liposomal amphotericin B therapeutic use in the management of fungal infections and visceral leishmaniasis. Drugs 55: 585–612.
-
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: 941–951.
-
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: 1494–1502.
-
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: 1155–1163.
-
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: 3774–3779.
-
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: 763–774.
| Past two years | Past Year | Past 30 Days | |
|---|---|---|---|
| Abstract Views | 248 | 184 | 15 |
| Full Text Views | 581 | 18 | 0 |
| PDF Downloads | 122 | 21 | 2 |