amphotericin b liposome / Generic mfg. - LARVOL DELTA

Multifocal Cryptococcus Neoformans Osteomyelitis in a Kidney Transplant Recipient. (PubMed, Indian J Nephrol) - "He was managed with surgical debridement, liposomal amphotericin B, flucytosine and reduction in maintenance immunosuppression (IS). To our knowledge this is the first reported case of multifocal cryptococcus osteomyelitis in a kidney transplant recipient."

Journal • Infectious Disease • Inflammation • Pain • Transplantation

INVASIVE FUNGAL DISEASE AND ANTIFUNGAL STEWARDSHIP IN PAEDIATRIC HAEMATOLOGY- ONCOLOGY PATIENTS IN THE REPUBLIC OF IRELAND (FUNGI-HOPE PROJECT) (ESPID 2025) - "Liposomal amphotericin B and posaconazole were prescribed at most as treatment and prophylaxis antifungals respectively. The full analysis of this study is still on-going both from quantitative and qualitative point of view. Conclusions/Learning Points This comprehensive study hopes to add important data on knowledge gaps, enhance understanding, and evaluate antifungal stewardship implementation in paediatric HO at CHI Crumlin and shared centres, which will improve patient outcomes and care practices."

Clinical • Infectious Disease

UNIFYING STRATEGIES: INSIGHTS INTO ANTIMICROBIAL PROPHYLAXIS IN PEDIATRIC TRANSPLANTATION ACROSS EUROPE – FINDINGS FROM THE ERN-TRANSPLANTCHILD SURVEY (ESPID 2025) - "Second- and third-generation cephalosporins are frequently used in renal and heart transplants, while piperacillin-tazobactam plus vancomycin is common for liver and lung transplants...Systematic antifungal prophylaxis is recommended in nearly half of intestinal and lung transplant programs and 30% of other types, with fluconazole and liposomal amphotericin B commonly used, except in lung transplants where triazoles are preferred. In HSCT, antimicrobial prophylaxis has a different rationale and antibiotics are used in 30% of autologous and 46% of allogeneic cases, typically until engraftment, with antifungal prophylaxis prescribed in 92% of programs. Conclusions/Learning Points Wide variability in antimicrobial prophylaxis and screening practices underscores the urgent need for standardised, evidence-based guidelines to optimise strategies."

Clinical

L-AmB_RUSCO: L-AmB_ Retrospective mUlticenter Study on Mycosis prOphylaxis (clinicaltrials.gov) - P=N/A | N=120 | Enrolling by invitation | Sponsor: Istituto Giannina Gaslini | Trial completion date: May 2025 ➔ May 2026 | Trial primary completion date: Dec 2024 ➔ Dec 2025

Trial completion date • Trial primary completion date • Dermatology • Infectious Disease • Pediatrics

Severe Pulmonary Involvement in Disseminated Histoplasmosis Leading to Hemophagocytic Lymphohistiocytosis in a Kidney Transplant Recipient: A Case Report (ATS 2025) - "The patient was started on Vancomycin, Cefepime, Azithromycin, and liposomal Amphotericin B, however he decompensated and required mechanical ventilation. In our patient, immunosuppressive therapy likely facilitated the dissemination of histoplasmosis, and subsequent rapid reduction in immunosuppression on admission then triggered HLH. Abruptly stopping immunosuppressive therapy in patients with disseminated fungal infections especially with severe lung infection, may contribute to the development of HLH; avoiding a sudden discontinuation of immunosuppression could potentially prevent this complication."

Case report • Clinical • Cough • Dyslipidemia • Genetic Disorders • Hematological Disorders • Hemophagocytic lymphohistiocytosis • Human Immunodeficiency Virus • Hypertriglyceridemia • Immunology • Infectious Disease • Nephrology • Polycystic Kidney Disease • Rare Diseases • Renal Disease • Respiratory Diseases • Solid Organ Transplantation • Transplantation • Tuberculosis • IL2RA • ISG20

The Leishmaniasis Enigma In Advanced HIV (ATS 2025) - "Antiretroviral (ART) and liposomal amphotericin B were started, and follow-up appointments were scheduled to evaluate his therapeutic response and course...ART to inhibit HIV replication and targeted anti-leishmanial treatment are essential to decrease the likelihood of delayed relapses and increase survival rates. Our case represents EBUS-TBNA's usefulness in identifying this parasitic infection within lymph nodes, with only 2 previously reported cases of endoscopy showing these findings."

Metastases • Anemia • Cytomegalovirus Infection • Endocrine Disorders • Hematological Disorders • Hepatitis B • Hepatitis C • Hepatology • Human Immunodeficiency Virus • Infectious Disease • Metabolic Disorders • Oncology • Pain • Respiratory Diseases • Tuberculosis • CD4

A Novel Clinical Presentation: First Documented Case of Candida Auris Empyema Thoracis (ATS 2025) - "He was found to have pneumonia due to Pseudomonas, and was treated with parenteral cefepime...He was treated with meropenem, vancomycin, anidulafungin, and liposomal amphotericin B. The pleural C. auris strain was susceptible to anidulafungin (MIC = 0.25 ug/ml)...We await the results of ongoing clinical trials with newly developed phase 2 clinical trial antifungal agents such as fosmanogepix, ibrexafungerp, and T-2307, a novel arylamidine, for advances in anti-C. auris treatment options."

Clinical • Acute Kidney Injury • Diabetes • Diabetic Nephropathy • Infectious Disease • Metabolic Disorders • Pneumonia • Renal Disease • Respiratory Diseases • Septic Shock

Endobronchial Intracavitary Amphotericin B Instillation for Treatment of Aspergilloma: A Case Report (ATS 2025) - "The patient underwent robotic bronchoscopy with the Ion robot, receiving 50 mg of liposomal amphotericin B in 20 mL of 5% dextrose instilled into the lesion...This case illustrates the potential of intracavitary amphotericin B as a treatment option for large pulmonary aspergillomas in patients with severe comorbidities who are not candidates for surgery. Robotic bronchoscopy facilitated precise drug delivery to the aspergilloma, offering a targeted, minimally invasive approach for patients ineligible for conventional therapies due to factors such as cachexia and advanced pulmonary disease."

Case report • Clinical • Bronchiectasis • Cachexia • Diabetes • Metabolic Disorders • Oncology • Pancreatitis • Pulmonary Disease • Pulmonary Emphysema • Respiratory Diseases • Type 2 Diabetes Mellitus

Severe Disseminated Histoplasmosis With Secondary Hemophagocytic Lymphohistiocytosis in a Renal Transplant Patient (ATS 2025) - "A 76 year-old female with a history of end stage renal disease secondary to lupus, status-post renal transplant in 2021, on immunosuppressive therapy with tacrolimus, mycophenolate mofetil, and prednisone presented with two months of malaise, fevers, odynophagia and right-sided cervical lymphadenopathy...Treatment with intravenous liposomal amphotericin B and intravenous Isavuconazole was initiated...She was treated with intravenous immunoglobulin, Anakinra, Ruxolitinib, and Dexamethasone with normalization of soluble IL-2. Etoposide was avoided due to concurrent risk of worsening her disseminated fungal infection...This case highlights the importance of maintaining a high index of suspicion for fungal infections, such as histoplasmosis, and HLH in transplant patients who present with nonspecific symptoms such as fever, malaise, and pancytopenia even in non-endemic regions. Treatment of histoplasmosis-related secondary HLH is challenging, balancing the need for..."

Clinical • Cervical Cancer • Cytomegalovirus Infection • Gastroenterology • Gastrointestinal Disorder • Hematological Disorders • Hemophagocytic lymphohistiocytosis • Human Immunodeficiency Virus • Immunology • Infectious Disease • Inflammatory Arthritis • Lupus • Nephrology • Oncology • Pneumonia • Rare Diseases • Renal Disease • Respiratory Diseases • Septic Shock • Transplantation • IL2

Iatrogenic Immunosuppression, Disseminated Histoplasmosis, and COVID-19 Leading to Hemophagocytic Lymphohistiocytosis (ATS 2025) - "Upon return from her trip, outpatient blood work led to a hospital referral where she was diagnosed with COVID-19 and treated with remdesivir...After requiring massive transfusions for gastrointestinal bleeding, dexamethasone was started for empiric HLH treatment...Due to worsening clinical status, anakinra was initiated...Liposomal amphotericin B was started...Due to under recognition of HLH, lack of concomitant fulfillment of diagnostic criteria, and varying scoring systems, earlier intervention is often precluded. If on the differential, consideration should be made for empiric treatment of HLH as the evidence in support grows stronger."

Chronic Kidney Disease • Endocrine Disorders • Gastroenterology • Gastrointestinal Disorder • Glomerulonephritis • Hematological Disorders • Hemophagocytic lymphohistiocytosis • Human Immunodeficiency Virus • Hypertriglyceridemia • IgA Nephropathy • Immunology • Infectious Disease • Metabolic Disorders • Myelodysplastic Syndrome • Nephrology • Novel Coronavirus Disease • Oncology • Rare Diseases • Renal Disease • Respiratory Diseases • Rheumatology • Septic Shock • IL2

An Important Suspect: Fungal Pneumonia in Intensive Care: A Case Series (ATS 2025) - "Injection voriconazole was started...He was given liposomal amphotericin B followed by posaconazole...Case 4 signifies that even when clinical features are non-specific, evaluation is required if patient is immunocompromised. This case series also calls for the need for a comprehensive diagnostic algorithm for fungal pneumonia in intensive care units, irrespective of host factors."

Clinical • Cardiovascular • Chronic Obstructive Pulmonary Disease • Congestive Heart Failure • Cough • Critical care • Diabetes • Glomerulonephritis • Heart Failure • Immunology • Infectious Disease • Influenza • Lupus Nephritis • Metabolic Disorders • Nephrology • Pneumonia • Respiratory Diseases

Racing Against Time: Pulmonary Mucormycosis in a Kidney Transplant Recipient Under Experimental Anti-rejection Therapy (ATS 2025) - "He had received the transplant one month prior and was started on immunosuppressive therapy, including mycophenolate, prednisone, and a humanized monoclonal antibody currently under investigation for preventing kidney transplant rejection.On examination, he was afebrile, with a blood pressure of 156/71 mmHg, oxygen saturation of 95%, respiratory rate of 17 breaths per minute, and a heart rate of 72 beats per minute. Initial laboratory results showed a white blood cell count of 9.2 K/μL (normal range 4.5-11 K/μL), and a lactic acid level of 0.8 mmol/L (normal range 0.3-2 mmol/L).Due to his immunosuppressed state, empirical treatment with vancomycin, cefepime, and metronidazole was initiated...However, a positive Beta-D-glucan (BDG) test at 127 pg/mL (reference range < 60 pg/mL) raised concern for an invasive fungal infection, leading to the initiation of liposomal amphotericin B and isavuconazole...In immunocompromised patients, the main route of infection seems to be..."

Clinical • Chronic Kidney Disease • Cough • Fatigue • Focal Segmental Glomerulosclerosis • Glomerulonephritis • Hematological Malignancies • Immunology • Infectious Disease • Leukemia • Nephrology • Oncology • Renal Disease • Respiratory Diseases • Transplant Rejection • Transplantation

From Chest to Toe: A Case of Disseminated Coccidioidomycosis Immediately Post Renal Transplant (ATS 2025) - "She reported strict adherence to the prescribed immunosuppressant regimen (mycophenolate, tacrolimus, prednisone) and post-transplant infectious prophylaxis (atovaquone, fluconazole, and valganciclovir)...She was empirically treated with piperacillin-tazobactam and remained on prophylactic atovaquone and valganciclovir while awaiting serologic and sputum studies, including expectorated MTB-PCR...On day four, a positive 1,3-beta-D-glucan prompted the initiation of posaconazole...She was started on IV liposomal amphotericin B after blood and right hallux vesicle cultures confirmed fungemia and cutaneous involvement...She was discharged home on a prolonged course of voriconazole for disseminated coccidioidomycosis, with ongoing symptomatic and radiographic improvement...Donor-derived Coccidioides typically presents within one month of transplant with severe infection and carries a mortality rate nearing 30%. Although routine fungal prophylaxis has reduced the incidence of..."

Clinical • Cough • Dermatology • Glomerulonephritis • IgA Nephropathy • Infectious Disease • Nephrology • Pain • Renal Disease • Respiratory Diseases • Solid Organ Transplantation • Transplantation • Tuberculosis

Triumph Over Pulmonary Mucormycosis With Posaconazole: Not Always the MAC Infection? (ATS 2025) - "Her medical history included bronchiectasis, systemic lupus erythematosus managed with prednisone and hydroxychloroquine, and recurrent MAC infections previously treated with azithromycin, ethambutol, and rifampin with MAC disease in remission...High-dose liposomal amphotericin B is the recommended first-line treatment, with intravenous isavuconazole and posaconazole as subsequent options. This case highlights the importance of considering pulmonary mucormycosis in patients with complex lung diseases and the efficacy of targeted antifungal therapy. Continued vigilance in diagnosis and treatment can significantly improve outcomes in this vulnerable patient population."

Bronchiectasis • Cough • Fatigue • Immunology • Infectious Disease • Inflammatory Arthritis • Lupus • Pneumonia • Pulmonary Disease • Respiratory Diseases • Systemic Lupus Erythematosus

Uncommon Encounter a Rare Co-infection of Cryptococcus and Staphylococcus in an Immunocompetent Patient (ATS 2025) - "The patient received IV cefazolin for MSSA, and, following a negative lumbar puncture, antifungal therapy was transitioned from liposomal amphotericin B and flucytosine to oral fluconazole. This case illustrates a rare co-infection of S. aureus and C. neoformans in an immunocompetent patient, challenging assumptions about host immunity in fungal infections. This rare dual infection in an immunocompetent patient highlights the importance of subtle risk factors like diabetes and COPD in lowering resistance to atypical infections. The potential interaction between C. neoformans and S. aureus, with C. neoformans potentially facilitating secondary abscess formation, underscores the complexity of co-infections. A multidisciplinary approach, combining medical and surgical interventions, was essential for infection control."

Clinical • Chronic Obstructive Pulmonary Disease • Diabetes • Genetic Disorders • Immunology • Infectious Disease • Metabolic Disorders • Obesity • Pain • Respiratory Diseases • Septic Shock • Type 2 Diabetes Mellitus

A Rare Pair: Mucormycosis and Pneumocystis Coinfection in a Mantle Cell Lymphoma Patient on Pirtobrutinib (ATS 2025) - "She was started on systemic and retrobulbar liposomal amphotericin-B, vancomycin, and cefepime. Cultures grew Rhizopusand ESBL Klebsiella pneumoniae, prompting a switch of bacterial coverage to ertapenem...Remdesivir, TMP/SMX, and posaconazole were added. Given increasing ventilatory settings, the decision to start prednisone 40mg BID was made...Concurrent IFIs, as observed in this case, are rare. Patients on BTKis who have additional IFI risk factors—such as uncontrolled diabetes, corticosteroid use, and recent COVID-19 infection—may benefit from prophylactic TMP/SMX and require close monitoring."

Clinical • Acute Kidney Injury • Acute Respiratory Distress Syndrome • Anemia • Cardiovascular • Cough • Diabetes • Hematological Disorders • Hematological Malignancies • Infectious Disease • Lymphoma • Mantle Cell Lymphoma • Metabolic Disorders • Nephrology • Novel Coronavirus Disease • Oncology • Otorhinolaryngology • Pneumonia • Pulmonary Disease • Pulmonary Embolism • Renal Disease • Respiratory Diseases • Septic Shock • Thrombocytopenia • Type 2 Diabetes Mellitus

Cavitary Pulmonary Lesion in a Renal Transplant Recipient: Role of Tissue Sampling in Diagnosing Mucormycosis (ATS 2025) - "Management and Outcome: The patient was treated with intravenous liposomal amphotericin B and repeat imaging revealed progression of the lesion...1E) and postoperatively, the patient was transitioned to oral isavuconazole for a planned three month course. Immunosuppression was significantly reduced, with tacrolimus levels targeted at 2-4 ng/mL and mycophenolate mofetil held... This case highlights the importance of obtaining tissue biopsy in immunosuppressed hosts presenting with pulmonary cavitary lesions. Lack of airway communication with the cavity may result in negative BAL cultures. TBNA and biopsy sampling, either using peripheral navigation technology or linear EBUS as in our case increases the likelihood of representative sampling."

Clinical • Cardiovascular • Cough • Diabetes • Dyslipidemia • Hypertension • Infectious Disease • Metabolic Disorders • Respiratory Diseases • Transplantation • Type 1 Diabetes Mellitus

A Sinister Syndrome: A Rare Case of Disseminated Histoplasmosis as an AIDS-defining Illness (ATS 2025) - "Treatment for disseminated histoplasmosis was initiated with liposomal Amphotericin B, along with HAART with careful monitoring for IRIS. The patient rapidly improved over the next few days; declining renal function prompted a switch to oral Itraconazole on which he was eventually discharged. Patient has since followed up with his PCP and is compliant with therapy."

Clinical • Anemia • Cough • Dermatology • Hematological Disorders • Human Immunodeficiency Virus • Hypotension • Infectious Disease • Pulmonary Disease • Respiratory Diseases • Tuberculosis • CD4

The Intoxicated Patient Who Cried Wolf: A Concealed Case of Obstructive Hydrocephalus From Cryptococcal Meningoencephalitis in Alcoholic Cirrhosis (ATS 2025) - "Treatment was initiated with liposomal amphotericin B and flucytosine followed by consolidation and maintenance with fluconazole...Cerebral dysfunction from alcoholic cirrhosis and intoxication may confound identification of common symptoms like confusion or headache encountered with cryptococcal CNS infection. This case highlights the need for a high index of suspicion for opportunistic infections as a cause for encephalopathy in patients with cirrhosis."

Clinical • Addiction (Opioid and Alcohol) • CNS Disorders • Epilepsy • Fibrosis • Hepatic Encephalopathy • Hepatology • Human Immunodeficiency Virus • Immunology • Infectious Disease • Inflammation • Liver Failure • Pain • Ventriculomegaly

Clot Over Chaos: A Unique Case of Fungal Endocarditis and Superior Vena Cava Thrombosis (ATS 2025) - "Postoperatively, the patient's condition gradually improved, and he was continued on antifungal therapy with liposomal amphotericin B for 8 weeks...Optimal treatment typically includes long-term antifungal therapy combined with surgical intervention within one week of diagnosis, as recommended by the European Society of Clinical Microbiology and Infectious Diseases. This case highlights how high clinical suspicion and prompt intervention achieved a successful outcome in a young patient, even in a resource-limited country."

Clinical • Cardiovascular • Cough • Hematological Disorders • Infectious Disease • Respiratory Diseases • Thrombocytopenia • Thrombosis

Mucormycosis Endocarditis: A Rare Case of Native Valve Involvement (ATS 2025) - "Karius PCR testing of MV tissue yielded Mucor circinelloides, Enterococcus faecium, and Streptococcus pyogenes; treatment with six-weeks of daptomycin and liposomal amphotericin B was started. This case underscores the role of advanced diagnostics like cell-free DNA sequencing in identifying pathogens when conventional methods fall short. The patient's survival, despite significant morbidity, raises the question of whether mucormycosis may be underrecognized in patients with subtle immune compromise from conditions like cirrhosis."

Clinical • Cardiovascular • Dermatology • Fibrosis • Gastroenterology • Hepatitis C • Hepatology • Immunology • Infectious Disease • Inflammation • Pain • Pneumonia • Pulmonary Disease • Respiratory Diseases • Septic Shock

Detecting the Rare With Limited Resources: A Case of Suspected Disseminated Histoplasmosis (ATS 2025) - "Subsequent blood cultures grew yeast, identified as Candida species, and he started on Micafungin...Liposomal Amphotericin B was started pending further results...UpToDate. https://www.uptodate.com/contents/pathogenesis-and-clinical-manifestations-of-disseminated-histoplasmosis"

Clinical • CNS Disorders • Endocrine Disorders • Genito-urinary Cancer • Hematological Disorders • Hepatology • Infectious Disease • Oncology • Prostate Cancer • Respiratory Diseases • Solid Tumor • Thrombocytopenia

Mucous Plug Unmasking Pulmonary Mucormycosis in Liver Transplant Recipient (ATS 2025) - "Risk factors include acidosis, hyperglycemia, steroid use, and dialysis with deferoxamine...Treatment involves liposomal amphotericin B, debridement, and reducing risk factors. Post-transplant infections complicate management as immunosuppression promotes infection. A multidisciplinary approach is crucial to balance preventing rejection and controlling the aggressive fungal infection."

Clinical • Acute Kidney Injury • Atrial Fibrillation • Cardiovascular • CNS Disorders • Diabetes • Fibrosis • Hepatology • Immunology • Infectious Disease • Metabolic Disorders • Nephrology • Portal Hypertension • Renal Disease • Transplantation

Disseminated Coccidioidomycosis in an 83-year-old Man Post COVID-19 Pneumonia (ATS 2025) - "Following a course of molnupiravir, he initially improved but subsequently developed recurrent fevers (102°F), weakness, and right lower lobe pneumonia, necessitating hospitalization...A CT scan confirmed middle lobe pneumonia with scattered upper lobe micronodules and mediastinal lymphadenopathy.Despite empiric antibiotics (zosyn, doxycycline, and azithromycin), his respiratory status worsened, requiring intubation...Although serology for coccidioidomycosis was initially negative, antifungal treatment with micafungin and voriconazole was started and later escalated to liposomal amphotericin B due to his declining condition...The delayed diagnosis due to overlapping symptoms with bacterial pneumonia and COVID-19 sequelae limited the effectiveness of treatment. Early recognition and treatment are key to improving outcomes in cases of disseminated coccidioidomycosis, particularly in vulnerable patients with complex medical backgrounds (Agarwal et al., 2022; Al-Daraji..."

Acute Kidney Injury • Age-related Macular Degeneration • Cardiovascular • Coronary Artery Disease • Diabetes • Dyslipidemia • Hypertension • Hypotension • Infectious Disease • Macular Degeneration • Metabolic Disorders • Nephrology • Novel Coronavirus Disease • Ophthalmology • Peripheral Arterial Disease • Pneumonia • Renal Disease • Respiratory Diseases • Retinal Disorders • Type 2 Diabetes Mellitus

A Conundrum Around Steroids for Diffuse Alveolar Hemorrhage in the Peri-engraftment Period (ATS 2025) - "The European Conference on Infections in Leukemia suggests quickly tapering steroids and treatment with liposomal amphotericin B (LamB)...She tested positive for COVID one day after SCT and was started on remdesivir and steroids...A methyl-prednisone pulse dose of 500 mg every 24 hours for three days, followed by a long taper for another 13 days, was instituted for DAH and possible PERDS...However, treating DAH with steroids could worsen invasive fungal infections. We urge clinicians to thoroughly consider the possibility of mucormycosis in the peri-engraftment period for patients presenting with DAH prior to high doses of steroids."

Acute Respiratory Distress Syndrome • Bone Marrow Transplantation • Hematological Disorders • Hematological Malignancies • Immunology • Infectious Disease • Inflammatory Arthritis • Leukemia • Lupus • Novel Coronavirus Disease • Oncology • Respiratory Diseases • Systemic Lupus Erythematosus