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Failure of liposomal amphotericin B therapy in patients with severe pancreatitis complicated by Candida lusitaniae infection

  • Akitoshi Takuma
    Affiliations
    Department of Pharmacy, Showa University Northern Yokohama Hospital, Chigasaki Chuo 35-1, Tsuzuki-ku, Yokohama City Kanagawa, 224-8503, Japan

    Department of Hospital Pharmaceutics, School of Pharmacy, Showa University, Hatanodai 1-5-8, Shinagawa-ku, Tokyo, 142-8555, Japan
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  • Erika Inoue
    Affiliations
    Department of Pharmacy, Showa University Northern Yokohama Hospital, Chigasaki Chuo 35-1, Tsuzuki-ku, Yokohama City Kanagawa, 224-8503, Japan
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  • Kenji Momo
    Correspondence
    Corresponding author.
    Affiliations
    Department of Hospital Pharmaceutics, School of Pharmacy, Showa University, Hatanodai 1-5-8, Shinagawa-ku, Tokyo, 142-8555, Japan
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  • Takanori Kuroki
    Affiliations
    Department of Digestive Disease Center, Northern Yokohama Hospital, Chigasaki Chuo 35-1, Tsuzuki-ku, Yokohama City Kanagawa, 224-8503, Japan
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  • Takeshi Uchikura
    Affiliations
    Department of Hospital Pharmaceutics, School of Pharmacy, Showa University, Hatanodai 1-5-8, Shinagawa-ku, Tokyo, 142-8555, Japan
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  • Toru Watanabe
    Affiliations
    Department of Pharmacy, Showa University Northern Yokohama Hospital, Chigasaki Chuo 35-1, Tsuzuki-ku, Yokohama City Kanagawa, 224-8503, Japan

    Department of Hospital Pharmaceutics, School of Pharmacy, Showa University, Hatanodai 1-5-8, Shinagawa-ku, Tokyo, 142-8555, Japan
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  • Tadanori Sasaki
    Affiliations
    Department of Pharmacy, Showa University Hospital, Hatanodai 1-5-8, Shinagawa-ku, Tokyo, 142-8555, Japan
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Published:October 28, 2022DOI:https://doi.org/10.1016/j.jiac.2022.10.011

      Abstract

      Candida lusitaniae is an uncommon pathogen that accounts for approximately 1% of patients with candidiasis. In this report, we present the case of a 24-year-old woman with severe pancreatitis who was emergently admitted to Northern Yokohama Hospital. We started treating the pancreatitis and infections according to her culture results. However, her symptoms, accompanied by a necrotic pancreas, did not improve. Finally, C. lusitaniae was detected in the blood and catheter samples. We started antifungal treatment according to the culture results, but the patient died.
      Generally, the mortality rate for acute pancreatitis ranges from 3% for patients with interstitial edematous pancreatitis to 17% for those who develop pancreatic necrosis. Although we chose appropriate antibiotics and antifungal agents based on the culture results, the treatments failed. Early detection, sufficient doses of antimicrobials and frequent monitoring using sample culture are crucial because infection control may be inadequate, especially in tissues with low blood flow, such as necrotic tissues.

      Keywords

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      References

        • Banks P.A.
        • Freeman M.L.
        Practice parameters committee of the American college of gastroenterology. Practice guidelines in acute pancreatitis.
        Am J Gastroenterol. 2006; 101: 2379https://doi.org/10.1111/j.1572-0241.2006.00856.x
        • Lu J.D.
        • Cao F.
        • Ding Y.X.
        • Wu Y.D.
        • Guo Y.L.
        • Li F.
        Timing, distribution, and microbiology of infectious complications after necrotizing pancreatitis.
        World J Gastroenterol. 2019; 25: 5162-5173https://doi.org/10.3748/wjg.v25.i34.5162
        • Atkinson B.J.
        • Lewis R.E.
        • Kontoyiannis D.P.
        Candida lusitaniae fungemia in cancer patients: risk factors for amphotericin B failure and outcome.
        Med Mycol. 2008; 46: 541-546https://doi.org/10.1080/13693780801968571
        • Pfaller M.A.
        • Andes D.R.
        • Diekema D.J.
        • Horn D.L.
        • Reboli A.C.
        • Rotstein C.
        • et al.
        Epidemiology and outcomes of invasive candidiasis due to non-albicans species of Candida in 2,496 patients: data from the Prospective Antifungal Therapy (PATH) registry 2004-2008.
        PLoS One. 2014; 9e101510https://doi.org/10.1371/journal.pone.0101510
        • Yamaguchi H.
        • Uchida K.
        • Nishiyama Y.
        • Japan Antifungal Surveillance Program Group
        Species distribution and in vitro susceptibility to three antifungal triazoles of clinical Candida isolates from a five-year nation-wide survey in Japan.
        Med Mycol Res. 2012; 3: 17-26
        • Timsit J.F.
        • Azoulay E.
        • Schwebel C.
        • Charles P.E.
        • Cornet M.
        • Souweine B.
        • et al.
        Empirical micafungin treatment and survival without invasive fungal infection in adults with icu-acquired sepsis, candida colonization, and multiple organ failure: the EMPIRICUS randomized clinical trial.
        JAMA. 2016; 316: 1555https://doi.org/10.1001/jama.2016.14655
        • Cohen Y.
        • Karoubi P.
        • Adrie C.
        • Gauzit R.
        • Marsepoil T.
        • Zarka D.
        • et al.
        Early prediction of Candida glabrata fungemia in nonneutropenic critically ill patients.
        Crit Care Med. 2010; 38: 826-830https://doi.org/10.1097/CCM.0b013e3181cc4734
        • Keighley C.
        • Chen S.C.-A.
        • Marriott D.
        • Pope A.
        • Chapman B.
        • Kennedy K.
        • et al.
        Candidaemia and a risk predictive model for overall mortality: a prospective multicentre study.
        BMC Infect Dis. 2019; 19: 445https://doi.org/10.1186/s12879-019-4065-5
        • Yang S.P.
        • Chen Y.Y.
        • Hsu H.S.
        • Wang F.D.
        • Chen L.Y.
        • Fung C.P.
        A risk factor analysis of healthcare-associated fungal infections in an intensive care unit: a retrospective cohort study.
        BMC Infect Dis. 2013; 13: 10https://doi.org/10.1186/1471-2334-13-10
        • Besselink M.G.
        • van Santvoort H.C.
        • Boermeester M.A.
        • Nieuwenhuijs V.B.
        • van Goor H.
        • Dejong C.H.C.
        • et al.
        Timing and impact of infections in acute pancreatitis.
        Br J Surg. 2009; 96: 267https://doi.org/10.1002/bjs.6447