Amphotericin children

Manley TJ, Chusid MJ, Rand SD, Wells D, Margohs DA. Reversible parkinsonism in a child after bone marrow transplantation and lipid-based amphotericin B therapy. Pediatr Infect Dis J 1998 17(5) 433-4. 

Amphotericin B lipid complex for neonatal invasive candidiasis. Arch Dis Child Fetal Neonatal Ed 2001 84(2) F131-3. 

Antoniskis et al reported four cases of reversible acute kidney injury in patient with AIDS who received both intravenous pentamidine (for PCP) and amphotericin B (for systemic mycoses). Of note, nephrotoxicity did not develop in three AIDS patients treated with both TMP-SMZ and amphotericin B or in two patients who concomitantly received inhaled pentamidine and amphotericin B [160]. Reports of renal damage in patients receiving parenteral pentamidine for the treatment of non-HIV diseases continue. Reversible acute kidney injury and nephrotic syndrome were documented in a young child given pentamidine mesylate and an antimonial salt for the treatment of visceral leishmaniasis [161]. In Africa (Kenya) patients with visceral leishmaniasis have developed renal toxicity during prolonged treatment (1 to 10 months) with pentamidine [162]. 

The incidence of Candidiasis reported in this series is disturbing because of the recent association of Candidiasis with parenteral nutrition, by Ashcraft and Leape (5). The work of MacMillan, Law and Holder, however, documents the increasing problem of Candida in the burned child (6). Because of the number of variables involved, it is difficult in this series to assess the relationship between Candidiasis and central venous nutritional supplementation. The clinician caring for this type of patient, however, should be aware of this etiologic possibility when sepsis presents and treat when present by removing catheters and giving Amphotericin B. 

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