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Liposomal amphotericin B-induced reversible ototoxicity in a patient with disseminated histoplasmosis
Ramadoss Ramu1, Brijesh Sharma1, Dheeresh Karunakara1
1Department of Medicine PGIMER and Dr. RML Hospital, New Delhi, India.
Abstract:
Amphotericin B (AmB) is a polyene antifungal agent used widely for systemic fungal infections. Infusion-related side effects, nephrotoxicity, and dyselectrolytemia are well-known adverse effects with the use of this drug. Liposomal preparation of AmB has less adverse events. However, ototoxicity due to AmB is scarcely mentioned in the literature. We report a case of disseminated histoplasmosis who was treated with liposomal amphotericin B (LAmB) and developed hearing loss during the treatment, which recovered after discontinuing the drug. This is a rare adverse effect of LAmB and reported only once from India, to the best of our knowledge.
Insights
Liposomal amphotericin B (LAmB), used for fungal infections, may cause hearing loss. This rare ototoxicity resolved after stopping the LAmB treatment in a patient with disseminated histoplasmosis.
Area of Science:
- Mycology
- Pharmacology
- Ototoxicology
Background:
- Amphotericin B (AmB) is a critical antifungal medication for systemic mycoses.
- Common adverse effects include infusion reactions, nephrotoxicity, and electrolyte imbalances.
- Liposomal formulations (LAmB) aim to reduce AmB's toxicity profile.
Observation:
- A patient with disseminated histoplasmosis developed hearing loss during LAmB therapy.
- The ototoxicity manifested during the course of treatment with liposomal amphotericin B.
- Hearing function improved after the discontinuation of LAmB.
Findings:
- This case highlights a rare instance of ototoxicity associated with liposomal amphotericin B.
- Hearing loss is an underreported adverse effect of LAmB.
- The reversibility of hearing loss suggests a direct link to LAmB exposure.
Implications:
- Clinicians should be vigilant for potential hearing impairment in patients receiving LAmB.
- Further research is warranted to understand the mechanism of LAmB-induced ototoxicity.
- This finding may influence treatment guidelines and patient monitoring for systemic fungal infections.
