Nebulized Liposomal Amphotericin B for Treatment of Pulmonary Infection Caused by Hormographiella aspergillata: Case Report and Literature Review

Abstract

Invasive fungal infection is a serious complication following allogeneic hematopoietic stem cell transplantation. Pulmonary infection due to Hormographiella aspergillata is an uncommon condition associated with a high mortality rate. The susceptibility of H. aspergillata to available antifungal agents is not well established. We report for the first time a case of H. aspergillata lung infection that responded poorly to conventional treatment with liposomal amphotericin B (LAmB; 3 mg kg of body weight per day) with renal damage at higher posology (5 mg kg of body weight per day), but improved rapidly after addition of nebulized LAmB to intravenous LAmB (3 mg kg of body weight per day). Successful treatment of our patient using nebulized LAmB would be worth evaluating in cases refractory to standard treatment or when the reference treatment may not be extended due to interaction or side effects.

Inducible Laryngeal Obstruction in the Paediatric Population – Review of the Literature and Current Understanding

“…This is important especially when some of the antibiotics required to treat multidrug resistant infections have serious systemic toxicity, but also given the concerns around antibiotic resistance and the need to control the doses of these powerful drugs. 7,106 There are many publications outlining the use of VMNs for delivery of heparin for pulmonary inflammation in ventilated patients, 32 antifungals for invasive aspergillosis, [107][108][109] furosemide for COPD exacerbations, surfactant for neonates, prostacyclins for pulmonary hypertension, bronchopulmonary dysplasia and breathlessness in lung cancer, 33,110,111 and the administration of insulin to patients with diabetes. [112][113][114] However, many of these drugs are not approved for inhalation or are not specifically approved for inhalation with a VMN and are off label.…”

Inhaled Liposomal Antimicrobial Delivery in Lung Infections

“…L-AmB may serve also as an alternative method of treatment for patients with pulmonary fungal infections either used alone or in combination with systemic treatment. Nebulized L-AmB has been used as adjunctive treatment in devascularized anastomotic infections in LTR and for fungal infections other than aspergillosis [70]. Furthermore, L-AmB may have a place in the treatment of patients with corticosteroid-dependent allergic bronchopulmonary aspergillosis [71].…”

The Curious Case of “Case Report” of Infections Caused by Human and Animal Fungal Pathogens: An Educational Tool, an Online Archive, or a Format in Need of Retooling

“…Severe paracoccidioidomycosis in a 14-year-old boy 200 1/1 [63] a Google Scholar/Scopus [41,42], France [43,44], India [45,46], Italy [47], Iran [48], Japan [49], Malaysia [50], Poland [51], UK [52], and USA [53,54]. There were no other discernible features among this group of case reports to account for the high downloads and citations except for a novelty or rarity of fungal pathogens, for example reports of two cases of multidrug-resistant yeast (Fereydounia khargensis) and of black-grain eumycetoma caused by the rare fungal pathogen Medicopsis romeroi [50,52].…”