amphotericin-b and Mitochondrial-Diseases

Topics: Amphotericin B; Anemia, Neonatal; Anemia, Sideroblastic; Antifungal Agents; Catheters, Indwelling; Deferoxamine; Dermatomycoses; DNA, Mitochondrial; Female; Hemochromatosis Protein; Heterozygote; Histocompatibility Antigens Class I; Humans; Infant; Infant, Newborn; Membrane Proteins; Metabolic Diseases; Methylprednisolone; Mitochondrial Diseases; Siderophores; Zygomycosis

Nebulized liposomal amphotericin B (20-15 mg twice daily by nebulizer) was combined with high dose intravenous liposomal amphotericin B (10 mg/kg/day) and high dose caspofungin (100 mg/m(2)) for the treatment of severe, recurrent pulmonary aspergillosis following allogeneic hematopoietic stem cell transplantation from alternative donor in a patient with mitochondrial disease (Pearson's syndrome). This combined treatment was administered for 8 days. Nebulized liposomal amphotericin B was well tolerated. Since severe transplant complications developed, nebulized administration was withdrawn and intravenous doses of liposomal amphotericin B and caspofungin were tapered to usual schedules. Pulmonary aspergillosis responded well to 45 days of combined intravenous antifungal therapies which were maintained for 2 years with secondary prophylaxis, because of persistent immunosuppressive treatment.

Topics: Administration, Inhalation; Amphotericin B; Antifungal Agents; Aspergillosis; Caspofungin; Drug Combinations; Drug Therapy, Combination; Echinocandins; Female; Hematopoietic Stem Cell Transplantation; Humans; Injections, Intravenous; Lipopeptides; Lung Diseases, Fungal; Mitochondrial Diseases; Peptides, Cyclic; Phosphatidylcholines; Phosphatidylglycerols; Syndrome; Transplantation, Homologous