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Central nervous system toxicity associated with liposomal amphotericin B therapy for cutaneous leishmaniasis

Jessie S Glasser1, Clinton K Murray

  • 1US Infectious Disease Service, Brooke Army Medical Center, 3851 Roger Brooke Drive, Fort Sam Houston, TX 78234, USA. Jessie.glasser@amedd.army.mil

The American Journal of Tropical Medicine and Hygiene
|April 5, 2011
PubMed

Insights

Liposomal amphotericin B, used for fungal and leishmaniasis infections, can cause temporary cognitive issues like memory loss and confusion. This side effect may occur even in healthy individuals without other health problems.

Area of Science:

  • Pharmacology
  • Infectious Diseases
  • Neurology

Background:

  • Liposomal amphotericin B (AmBisome) is a key antifungal and antileishmanial agent.
  • Neurologic toxicities are listed as potential side effects, but specific case reports are rare, especially in healthy patients.
  • Cutaneous leishmaniasis is treated with AmBisome, particularly in endemic regions or for military personnel deployed in such areas.

Observation:

  • A healthy 38-year-old male developed memory difficulties and confusion after completing a course of liposomal amphotericin B for cutaneous leishmaniasis.
  • No other cause for the cognitive symptoms was identified.
  • The patient's symptoms resolved spontaneously within weeks.

Findings:

  • This case suggests that liposomal amphotericin B can cause reversible cognitive side effects, such as memory impairment and confusion.
  • The observed toxicity occurred in a patient without comorbidities, highlighting a potential risk even in healthy populations.
  • The resolution timeline aligns with the known pharmacokinetic profile of liposomal amphotericin B.

Implications:

  • Clinicians should be aware of the potential for cognitive side effects with liposomal amphotericin B, even in immunocompetent patients.
  • Early recognition and monitoring of neurologic symptoms are important during and after treatment.
  • Further research may be warranted to fully characterize the incidence and risk factors for AmBisome-associated neurotoxicity.

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