amphotericin-b and Cardiomyopathy--Dilated

Amphotericin B (AmB) is commonly used to treat a broad spectrum of fungal infections and leishmaniasis. Its use is limited by numerous adverse effects. Reversible dilated cardiomyopathy associated with AmB is a rare disorder with only four previously reported cases, and all of them referring to patients who presented with a predisposing factor for heart failure.. A previously healthy 45-year-old man with visceral leishmaniasis treated with AmB developed acute dilated cardiomyopathy. Other causes of heart failure as well-known predisposing factors for this condition were ruled out. As with previously reported cases, the cardiac function of our patient returned to normal shortly after.. We describe the first case of dilated cardiomyopathy associated with the administration of AmB in a patient without any known predisposing factor for developing cardiac dysfunction. Available evidence suggests that AmB may induce cardiotoxicity. Further investigations are needed to clarify this issue.

Topics: Amphotericin B; Antiprotozoal Agents; Cardiomyopathy, Dilated; Humans; Leishmaniasis, Visceral; Male; Middle Aged

Zygomycosis is an opportunistic fungal infection mainly affecting patients with diabetes mellitus, immunodeficiency, and malignancies. The majority of cases in which it has been reported as a posttransplantation complication have been after renal or liver transplantation. There are few instances of rhino-sinusitis and orbital mucormycosis complicating heart transplantation.. A 38-year-old diabetic man who had undergone heart transplantation returned to the transplantation follow-up clinic 20 days after a successful operation with unilateral periorbital swelling, nasal discharge, and multiple cranial nerve dysfunctions. Multidisciplinary investigations resulted in detection of mucormycosis in the paranasal sinuses and the orbital space, as well as a thrombosis of the cavernous sinus. Surgical ablation of the infected parts, along with antifungal treatment and adjustment of immunosuppressive maintenance, restricted extension of the craniofacial involvement. Allograft function remained undisturbed.. Early detection of opportunistic infections in transplant recipients plays a big role in preventing dissemination. Fungal infections, including zygomycosis, should be considered for recipients, especially those with risk factors, such as diabetes, who present with local unusual manifestations. Sinonasal and orbital mucormycosis, if diagnosed in timely fashion, can be managed to reduce mortality. Although devastation of one-side facial and ophthalmic structures was inevitable in this case, the overall outcome was acceptable.

Topics: Adult; Amphotericin B; Antifungal Agents; Blood Transfusion; Brain; Cardiomyopathy, Dilated; Diabetes Mellitus, Type 2; Erythema; Female; Heart Transplantation; Humans; Magnetic Resonance Imaging; Male; Mucormycosis; Rhinitis; Risk Factors; Tissue Donors; Tomography, X-Ray Computed; Treatment Outcome; Zygomycosis

Simultaneous mold infections in heart transplant recipients have not been previously reported. Here we describe early onset post-transplant pulmonary aspergillosis and cutaneous zygomycosis in a 46-year-old heart transplant recipient who was also treated with basiliximab. Along with surgical debridement, medical treatment of his cutaneous abdominal wall zygomycosis at the former left ventricular assist device driveline site with liposomal amphotericin B and voriconazole also led to cure of his pulmonary aspergillosis.

Topics: Amphotericin B; Antibodies, Monoclonal; Antifungal Agents; Aspergillus fumigatus; Basiliximab; Cardiomyopathy, Dilated; Debridement; Dermatomycoses; Heart Transplantation; Humans; Immunocompromised Host; Immunosuppressive Agents; Injections, Intravenous; Male; Middle Aged; Mucormycosis; Prosthesis-Related Infections; Pulmonary Aspergillosis; Pyrimidines; Recombinant Fusion Proteins; Rhizopus; Triazoles; Voriconazole

We describe a patient who developed dilated cardiomyopathy and clinical congestive heart failure after 2 months of therapy with amphotericin B (AmB) for disseminated coccidioidomycosis. His echocardiographic abnormalities and heart failure resolved after posaconazole was substituted for AmB. It is important to recognize the rare and potentially reversible toxicity of AmB.

Topics: Adult; Amphotericin B; Antifungal Agents; Cardiomyopathy, Dilated; Coccidioidomycosis; Drug Combinations; Echocardiography; Humans; Injections, Intravenous; Male; Phosphatidylcholines; Phosphatidylglycerols

Topics: Adult; Amphotericin B; Cardiomyopathy, Dilated; Coccidioidomycosis; Humans; Male

Topics: Adult; Amphotericin B; Aspergillosis; Aspergillus; Cardiomyopathy, Dilated; Heart Transplantation; Humans; Immunosuppression Therapy; Lung Diseases, Fungal; Male; Postoperative Complications; Tomography, X-Ray Computed