amphotericin-b and ST-Elevation-Myocardial-Infarction

Liposomal amphotericin B (L-AmB) is the cornerstone of many serious invasive fungal infections. Despite lower frequencies of commonly reported adverse events in clinical trials compared to conventional formulations, post-marketing complications continue to mount.. We present a case of chest pain following the initial dose of L-AmB for cryptococcal meningitis. Electrocardiogram demonstrated no acute electrocardiogram findings. Upon rechallenge, the chest pain worsened was subsequently accompanied by ST-segment elevation. Emergent coronary angiography found no acute findings.. Providers should be aware of cardiac complications with L-AmB, including non-occlusive ST-segment elevation.

Topics: Amphotericin B; Antifungal Agents; Electrocardiography; Humans; Male; Meningitis, Cryptococcal; Middle Aged; ST Elevation Myocardial Infarction

A 51-year-old man with a medical history of coronary artery disease and dyslipidaemia presented with acute myocardial infarction resulting in cardiogenic shock, necessitating intra-aortic balloon pump placement and extracorporeal membrane oxygenation (ECMO). His hospital course was complicated by several infectious complications including ECMO circuit

Topics: Amphotericin B; Anti-Bacterial Agents; Antifungal Agents; Ciprofloxacin; Cryptococcosis; Cryptococcus neoformans; Extracorporeal Membrane Oxygenation; Fluconazole; Flucytosine; Heart-Assist Devices; Humans; Immunocompetence; Intra-Aortic Balloon Pumping; Male; Middle Aged; Shock, Septic; ST Elevation Myocardial Infarction

Acute neurological events are a common cause of ECG abnormalities and transient elevations in cardiac biomarkers. This case describes an uncommon presentation of cryptococcal meningitis in a non-immunosuppressed patient, presenting with altered sensorium and derangements in cardiac profile. Delay in diagnosing meningitis was avoided by paying close attention to the patient's presenting symptoms and by pursuing non-cardiac causes of ECG changes and elevations in cardiac troponin. Expeditious treatment and involvement of the infectious disease consultant resulted in excellent clinical response without permanent neurological sequelae.

Topics: Amphotericin B; Antifungal Agents; Biomarkers; Cryptococcus neoformans; Delayed Diagnosis; Drug Therapy; Flucytosine; Humans; Male; Meningitis, Cryptococcal; Mental Disorders; Middle Aged; Pharyngeal Neoplasms; Spinal Puncture; ST Elevation Myocardial Infarction; Treatment Outcome