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Related Experiment Videos

Amphotericin pharmacophobia.

W S Symmers

    British Medical Journal
    |November 24, 1973
    PubMed
    Summary

    Fear of amphotericin B side effects in kidney disease patients led to fatal fungal infections. Untreated infections by Cryptococcus neoformans, Blastomyces dermatitidis, and Histoplasma capsulatum caused patient deaths.

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    Area of Science:

    • Mycology
    • Nephrology
    • Infectious Diseases

    Background:

    • Amphotericin B is a critical antifungal medication.
    • Patients with kidney disease often face treatment challenges due to potential nephrotoxicity.
    • Fungal infections can be life-threatening, especially in immunocompromised individuals.

    Purpose of the Study:

    • To report cases where withholding amphotericin B due to renal concerns led to fatal fungal outcomes.
    • To highlight the critical balance between managing kidney disease and treating severe fungal infections.

    Main Methods:

    • Case series review.
    • Analysis of five patient cases with severe fungal infections and kidney disease.
    • Documentation of treatment decisions and patient outcomes.

    Main Results:

    • Five patients with kidney disease died from progressive fungal infections (three Cryptococcus neoformans, one Blastomyces dermatitidis, one Histoplasma capsulatum).
    • In all cases, amphotericin B was withheld or its use was significantly delayed due to concerns about kidney function.
    • The fungal infections were sensitive to amphotericin B, indicating that treatment could have been effective.

    Conclusions:

    • Withholding or delaying amphotericin B treatment in patients with kidney disease due to fear of side effects can have fatal consequences.
    • Careful risk-benefit assessment is crucial when deciding on antifungal therapy in patients with renal impairment.
    • Effective management of life-threatening fungal infections should be prioritized, even in the presence of comorbidities like kidney disease.

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