Fatal fat embolism following amphotericin B lipid complex injection.
A case of amphotericin B lipid complex induced fatal fat embolism is described. A 41-year-old Caucasian man with AIDS was undergoing treatment for cryptococcal meningitis with amphotericin B. His course was complicated by renal failure necessitating a change in therapy to amphotericin B lipid complex (Abelcet). At approximately 48 h, the patient developed tachycardia, tachypnea, respiratory failure, decline in hematocrit, thrombocytopenia, and alteration in mental status. Autopsy findings included fat emboli involving heart, lungs, kidney, and brain. To our knowledge, this is the first case report of a fatal fat embolism caused by intravenous liposome drug delivery.
Tolentino
Lucilene F
LF
Department of Pathology, Harbor-UCLA Medical Center, Torrance, CA 90509, USA.
Tsai
Steve F
SF
Witt
Mallory D
MD
French
Samuel W
SW
D017088:AIDS-Related Opportunistic Infections / Q000150:complications / Q000188:drug therapy; D000328:Adult; D000666:Amphotericin B / Q000008:administration & dosage / Q000009:adverse effects*; D000935:Antifungal Agents / Q000008:administration & dosage / Q000009:adverse effects*; D001921:Brain / Q000382:microbiology / Q000473:pathology; D003455:Cryptococcus neoformans / Q000302:isolation & purification; D004338:Drug Combinations; D016503:Drug Delivery Systems; D004359:Drug Therapy, Combination; D004620:Embolism, Fat / Q000139:chemically induced* / Q000473:pathology; D005217:Fat Emulsions, Intravenous / Q000009:adverse effects*; D017809:Fatal Outcome; D006801:Humans; D007275:Injections, Intravenous; D008297:Male; D008578:Meninges / Q000382:microbiology / Q000473:pathology; D016919:Meningitis, Cryptococcal / Q000188:drug therapy; D010713:Phosphatidylcholines / Q000008:administration & dosage / Q000009:adverse effects*; D010715:Phosphatidylglycerols / Q000008:administration & dosage / Q000009:adverse effects*
D000935:Antifungal Agents; D004338:Drug Combinations; D005217:Fat Emulsions, Intravenous; D010713:Phosphatidylcholines; D010715:Phosphatidylglycerols; C068538:liposomal amphotericin B; D000666:Amphotericin B