ABSTRACT
Amphotericin B (AmB) is a polyene antifungal agent used widely for systemic fungal infections. Infusion-related side effects, nephrotoxicity, and dyselectrolytemia are well-known adverse effects with the use of this drug. Liposomal preparation of AmB has less adverse events. However, ototoxicity due to AmB is scarcely mentioned in the literature. We report a case of disseminated histoplasmosis who was treated with liposomal amphotericin B (LAmB) and developed hearing loss during the treatment, which recovered after discontinuing the drug. This is a rare adverse effect of LAmB and reported only once from India, to the best of our knowledge.
Subject(s)
Amphotericin B/adverse effects , Antifungal Agents/adverse effects , Histoplasmosis/drug therapy , Ototoxicity/etiology , Humans , Male , Middle AgedABSTRACT
Adult onset Still's disease (AOSD) is a rare inflammatory disorder of unknown etiology. It is a diagnosis of exclusion. We report a case of post-splenectomised man, presented with high grade fever, joint pain and body ache. Since Overwhelming Post Splenectomy Infection (OPSI) was the initial probable diagnosis, empirical antibiotic therapy was initiated. Evaluation to find a septic focus, autoimmune diseases ad malignancies was carried out which showed negative results. Since alternative diagnoses were excluded and the Yamaguchi's criteria for AOSD was fulfilled, the patient was treated with IV steroids which resulted in rapid resolution of his symptoms. AOSD with asplenia is a unique condition because immunosuppressive therapy for AOSD may increase the risk of OPSI in such a patient. This is the first case report of AOSD in an asplenic patient from India.
