title: Immediate hypersensitivity reaction following liposomal amphotericin-B (AmBisome) infusion.
abstract: Liposomal amphotericin-B (AmBisome) is now becoming first choice for the treatment of visceral leishmaniasis (kala-azar) patients due to high efficacy and less toxicity. The reported incidence of hypersensitivity reactions to liposomal amphotericin-B (AmBisome), especially during therapy, is very rare. We report two patients with kala-azar: one developed breathing difficulties and hypotension followed by shock and the other had facial angioedema with chest tightness during treatment. Both patients were managed with immediate action of injection: adrenaline, diphenhydramine and hydrocortisone. In our experience, AmBisome can cause severe hypersensitivity reactions that warrant proper support and close supervision.
authors.affiliation: Medical Officer, Surya Kanta Kala-azar Research Centre, Mymensingh Medical College Hospital, Bangladesh.
authors.forename: Proggananda
authors.initials: P
authors.lastname: Nath
authors.affiliation: Registrar & Incharge, Department of Infectious and Tropical Diseases, Mymensingh Medical College Hospital, Bangladesh arifulbasher@yahoo.com.
authors.forename: Ariful
authors.initials: A
authors.lastname: Basher
authors.affiliation: Research Fellow, Department of Hemodialysis & Apheresis, The University of Tokyo Hospital, Japan.
authors.forename: Michiyo
authors.initials: M
authors.lastname: Harada
authors.affiliation: Medical Officer, Surya Kanta Kala-azar Research Centre, Mymensingh Medical College Hospital, Bangladesh.
authors.forename: Santana
authors.initials: S
authors.lastname: Sarkar
authors.affiliation: Registrar, Department of Medicine, Shaheed Suhrawardy Medical College Hospital, Bangladesh.
authors.forename: Shahjada
authors.initials: S
authors.lastname: Selim
authors.affiliation: Senior Clinical Research Fellow, Mahidol-Oxford Tropical Medicine Research Unit, Thailand Senior Clinical Research Fellow and Honorary Consultant Physician, Centre for Tropical Medicine, Nuffield Department of Medicine, University of Oxford, UK.
authors.forename: Richard J
authors.initials: RJ
authors.lastname: Maude
authors.affiliation: Associate Professor, Department of Hemodialysis & Apheresis, The University of Tokyo Hospital, Japan.
authors.forename: Eisei
authors.initials: E
authors.lastname: Noiri
authors.affiliation: Professor and Director General of Health Services (Retired), Bangladesh.
authors.forename: Abul
authors.initials: A
authors.lastname: Faiz
mesh_terms: D000328:Adult; D000666:Amphotericin B / Q000009:adverse effects*; D001459:Bangladesh; D002648:Child; D004155:Diphenhydramine / Q000008:administration & dosage; D004630:Emergencies; D004837:Epinephrine / Q000008:administration & dosage; D005260:Female; D006801:Humans; D006854:Hydrocortisone / Q000008:administration & dosage; D006969:Hypersensitivity, Immediate / Q000139:chemically induced / Q000175:diagnosis* / Q000628:therapy; D007898:Leishmaniasis, Visceral / Q000188:drug therapy*; D008297:Male
chemical_list: C068538:liposomal amphotericin B; D000666:Amphotericin B; D004155:Diphenhydramine; D006854:Hydrocortisone; D004837:Epinephrine
keywords: AmBisome; Leishmaniasis