amphotericin-b and Fatigue

Meningitis, when caused by the fungal mycoses Cryptococcus neoformans, is normally seen in immuno-compromised hosts. However, immunocompetent patients are also susceptible to cryptococcal meningitis (CM). In patients with an intact immune system, CM usually presents with the typical signs and symptoms of meningitis: fever, stiff neck, and headache. Major implications for the primary and advanced practice nursing plans of care for CM patients include a thorough history and physical exam, early diagnosis and treatment, and an individualized plan of care focused on minimizing sequelae and side effects of treatment and maximizing functional recovery.

Topics: Amphotericin B; Antifungal Agents; Biopsy, Needle; Consciousness Disorders; Fatigue; Flucytosine; Headache; HIV Seronegativity; Humans; Immunocompetence; Male; Medical History Taking; Meningitis, Cryptococcal; Middle Aged; Nausea; Nurse's Role; Nursing Assessment; Patient Care Planning; Physical Examination; Recurrence; Tomography, X-Ray Computed; Ventriculoperitoneal Shunt

Amphotericin B lipid complex (ABLC), a lipid complex formulation of amphotericin B, and amphotericin B desoxycholate (AB) were compared for safety, tolerance, and pharmacokinetics in two groups of eight healthy male volunteers. After a 1-mg test dose, study drug was infused at 0.1, 0.25, and 0.5 mg/kg; the 0.5-mg/kg dose was not given to subjects receiving AB. ABLC caused few acute adverse effects except for mild somnolence (drowsiness) in six volunteers. In addition, three of eight ABLC recipient had asymptomatic, transient serum transaminase elevations that resolved spontaneously. The AB recipients experienced more acute side effects, but only one had a mild shaking chill: three of eight also experienced sleepiness. No significant changes in vital signs, electrocardiogram, oximetry, pulmonary function, or clinical status were observed in either group. Due to its increased estimate volume of distribution and estimated clearance. ABLC yielded decreased amphotericin B levels and area under the serum concentration versus time curve relative to AB.

Topics: Adult; Amphotericin B; Body Temperature; Drug Evaluation; Fatigue; Humans; Male; Oximetry; Sleep Stages

Topics: Aged; Amphotericin B; Antiprotozoal Agents; Arthritis, Rheumatoid; Fatigue; Female; Fluorescent Antibody Technique, Indirect; Hepatomegaly; Humans; Immunosuppressive Agents; Leishmania; Leishmaniasis, Visceral; Methotrexate; Splenomegaly; Tomography, X-Ray Computed

Leishmaniasis is a zoonotic disease which may be difficult to diagnose in children. Successful results have been achieved with amphotericin B in treatment. Here, we present a 7 month old girl who lives in Istanbul. She was given a diagnosis of kala-azar and treated with liposomal amphotericin B. Our case, born in Istanbul, had had fatigue for 3 weeks and pallor and abdominal distention for 2 days. History of travel was absent. In physical examination, paleness, malaise and hepatosplenomegaly were found. In laboratory findings there was pancytopenia and her albumin level was low. A peripheric smear and other laboratory findings were normal. Her first bone marrow aspiration was normal. Because of persistent fever and increase in hepatosplenomegaly, a second bone marrow aspiration was done on the tenth day after admission and Leismania amastigotes were seen. She was given a diagnosis of kala-azar and, clinical and microbiological responses were achieved by treatment with amphotericin B. In our country, visceral leishmaniasis should be considered in all age groups who live in western regions and have no history of travel and contact, that present with pancytopenia or bicytopenia, even if massive splenomegaly is absent.

Topics: Amphotericin B; Antiprotozoal Agents; Bone Marrow; Diagnosis, Differential; Fatigue; Female; Hepatomegaly; Humans; Infant; Leishmaniasis, Visceral; Liposomes; Pancytopenia; Splenomegaly; Turkey

A 71-year-old woman had suffered for 6 weeks from fatigue, dry cough and fever. Five years previously breast cancer had been diagnosed and had been successfully treated with subtotal mastectomy and postoperative radiotherapy, as well as aromatase inhibitor until shortly before the present admission. There was no history of travel to tropical countries, but during the last summer she had spent two weeks in Northern Italy. [corrected]. On admission the body temperature was 38,5 C with a mild tachycardia (108/min). Laboratory findings revealed a pancytopenia and slightly elevated liver enzymes. The ultrasound showed a hepatosplenomegaly. The investigation of the bone marrow showed a great amount of parasitic forms due to visceral leishmaniasis [corrected] TREATMENT, COURSE AND DIAGNOSIS: Treatment with liposomal amphotericin B brought about rapid improvement, the dry cough subsided and the laboratory results became normal.. Pancytopenia, fever, dry cough and hepatosplenomegaly after travelling to Mediterranean countries should raise suspicion of visceral leishmaniasis. This diagnosis is confirmed by direct detection of the parasite in the bone marrow. Administration of liposomal amphotericin B is efficacious and safe, bringing about full recovery in up to 90% of cases.

Topics: Aged; Amphotericin B; Antiprotozoal Agents; Aromatase Inhibitors; Breast Neoplasms; Chemotherapy, Adjuvant; Cough; Diagnosis, Differential; Fatigue; Female; Fever; Hepatomegaly; Humans; Italy; Leishmaniasis, Visceral; Liposomes; Mastectomy, Segmental; Pancytopenia; Prognosis; Radiotherapy, Adjuvant; Splenomegaly; Tachycardia; Travel

Topics: Aged; Amphotericin B; Antifungal Agents; Biopsy; Bone Marrow; Diagnosis, Differential; Fatigue; Fever; Histoplasmosis; Humans; Male; Pancytopenia; Weight Loss