Continuous intrathecal administration of liposomal amphotericin B for treatment of refractory Cryptococcus neoformans encephalitis: A case report

Xie,Haiting; Luo,Peng; Li,Zhongli; Li,Rui; Sun,Haitao; Wu,Duobin

doi:10.3892/etm.2017.4554

July-2017 Volume 14 Issue 1

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July-2017 Volume 14 Issue 1

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Case Report

Continuous intrathecal administration of liposomal amphotericin B for treatment of refractory Cryptococcus neoformans encephalitis: A case report

Authors:
- Haiting Xie
- Peng Luo
- Zhongli Li
- Rui Li
- Haitao Sun
- Duobin Wu
View Affiliations / Copyright

Affiliations: Department of Neurology, Zhujiang Hospital of Southern Medical University, Guangzhou, Guangdong 510282, P.R. China
Pages: 780-784
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Published online on: June 7, 2017

https://doi.org/10.3892/etm.2017.4554
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Abstract

The aim of the present study was to investigate the treatment of refractory Cryptococcus neoformans encephalitis with continuous administration of liposomal amphotericin B (AmB). Liposomal AmB was administered to a 28‑year‑old male by intravenous injection, with daily increasing dosages up to 150 mg per day and combined use of fluconazole (0.4 g per day) and oral flucytosine tablets (1.5 g per day). Following 5 months of treatment, C. neoformans could still be detected in the ink stain of cerebrospinal fluid, but the patient could not tolerate a further increase in the dosage of liposomal AmB. Instead, continuous intrathecal administration of AmB through tube drainage on the lumbar cistern was used. A total dosage of 28 mg liposomal AmB was administered to the patient over the course of 1 month. The effect of AmB administered by intravenous injection was not as great as expected and the patient's tolerance was not good. However, the patient recovered following treatment by continuous intrathecal administration of AmB through tube drainage on the lumbar cistern for 1 month. This case suggests that continuous intrathecal administration of liposomal AmB should be considered for clinical treatment of refractory cryptococcal encephalitis.

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