The utility of therapeutic plasma exchange for amphotericin B overdose

Transfus Apher Sci. 2018 Dec;57(6):756-758. doi: 10.1016/j.transci.2018.09.015. Epub 2018 Sep 18.

Abstract

Medication error is a preventable cause of morbidity and death in the inpatient population. We describe a patient with an antifungal overdose treated with therapeutic plasma exchange (TPE). The patient was diagnosed with cryptococcal meningitis and received an acute overdose of amphotericin B deoxycholate instead of the prescribed liposomal amphotericin B. Consequently, the patient developed clinical symptoms including tremors, hypertension, visual hallucinations, vertigo, fever, and acute renal failure. A series of four TPEs was emergently initiated, resulting in complete resolution of most symptoms.

Keywords: Cryptococcal meningitis; Medication error; Plasmapheresis; TPE.

Publication types

  • Case Reports

MeSH terms

  • Amphotericin B / adverse effects*
  • Amphotericin B / blood
  • Drug Overdose / therapy*
  • Humans
  • Kidney Function Tests
  • Male
  • Medication Errors
  • Middle Aged
  • Plasma Exchange*
  • Procedures and Techniques Utilization*

Substances

  • Amphotericin B