deoxycholic-acid and Sinusitis

Histoplasma capsulatum has not typically been associated with sinusitis in either immunocompetent or immunocompromised hosts. We report a case of sinusitis caused by H. capsulatum in a patient with chronic lymphocytic leukemia and discuss the reported cases of this rare clinical manifestation of histoplasmosis in the medical literature.

Topics: Aged; Amphotericin B; Antifungal Agents; Deoxycholic Acid; Drug Combinations; Histoplasma; Histoplasmosis; Humans; Immunocompromised Host; Itraconazole; Leukemia, Lymphocytic, Chronic, B-Cell; Male; Sinusitis; Treatment Outcome

Topics: Amphotericin B; Combined Modality Therapy; Deoxycholic Acid; Diagnosis, Differential; Drug Combinations; Eye Enucleation; Eye Infections, Fungal; Female; Humans; Middle Aged; Orbital Diseases; Rare Diseases; Schizophyllum; Sinusitis

Topics: Amphotericin B; Antifungal Agents; Child; Child, Preschool; Debridement; Deoxycholic Acid; Diabetes Mellitus, Type 1; Drug Combinations; Humans; Mucormycosis; Rhinitis; Sinusitis

Invasive aspergillosis is a severe complication in the immunocompromised patient. Despite antifungal treatment the mortality rate is higher than 90% if the immunity deficiency is not corrected. The use and dosage of conventional amphotericin B (deoxycholate-suspended formulation) is limited by its toxicity, especially nephrotoxicity. To reduce these untoward effects, amphotericin B has been formulated in liposomes. Better tolerance and lower nephrotoxicity in the liposomal formulations allow higher doses to be given safely, even in the presence of renal failure. Liposomal encapsulated amphotericin B (LAmB) is a safe and effective alternative to conventional formulations for antifungal therapy. We present a case of a 60-year-old man affected by chronic lymphocytic leukaemia. In the course of his disease and after chemotherapy treatment, he presented an invasive aspergillosis of the lung and paransal sinuses. The rhino-sinusal lesion had progressed despite surgical debridement and treatment with amphotericin B in a dosage of 50 mg per day. Moreover, renal impairment caused by conventional amphotericin was detected. Then, LAmB was started at a dose of 150 mg per day. Treatment with LAmB has resulted in clinical recovery and radiologic ressolution.

Topics: Amphotericin B; Antifungal Agents; Aspergillosis; Aspergillosis, Allergic Bronchopulmonary; Deoxycholic Acid; Drug Carriers; Drug Combinations; Humans; Leukemia, Lymphocytic, Chronic, B-Cell; Liposomes; Male; Middle Aged; Remission Induction; Sinusitis; Treatment Failure