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. 1972 Jul;48(561):436–440. doi: 10.1136/pgmj.48.561.436

Survival of candida septicaemia treated with amphotericin B

A B S Mitchell, G Hosking, I T Magrath, C P Farthing
PMCID: PMC2495243  PMID: 4560784

Abstract

Candida albicans septicaemia occurred in an alcoholic woman who had severe hepatic dysfunction, and was further debilitated by multiple cardiac arrests, prolonged artificial ventilation, bronchopneumonia and Ps. aeruginosa septicaemia. She received broad spectrum antibiotics and corticosteroids, and needed prolonged intravenous cannulation. In vitro, a specific defect was demonstrated in her cell-mediated immune response to candida antigens. Examination of her serum showed normal immunoglobulins, and an adequate agglutination titre to these antigens.

Amphotericin B (800 mg intravenously over 19 days) was administered, and she survived. Hypokalaemia, anaemia, and peripheral neuropathy complicated therapy, and thrombophlebitis of a cannulated peripheral vein necessitated a vena caval catheter. There was no significant deterioration of renal function.

Toxic effects of other drugs were encountered—deafness following kanamycin, an encephalopathy when blood levels of carbenicillin were boosted by probenecid, and cardiac arrest when diazepam and phenobarbitone were administered to control an epileptic fit and delirium tremens. Prolonged intravenous cannulation was complicated by staphylococcal septicaemia.

A year later she died of peritonitis. Chronic pancreatitis was complicated by ascites, which became infected by E. coli. No residual C. albicans infection was found at necropsy.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. BRANDRISS M. W., WOLFF S. M., MOORES R., STOHLMAN F., Jr ANEMIA INDUCED BY AMPHOTERICIN B. JAMA. 1964 Aug 31;189:663–666. doi: 10.1001/jama.1964.03070090013003. [DOI] [PubMed] [Google Scholar]
  2. BUTLER W. T., BENNETT J. E., ALLING D. W., WERTLAKE P. T., UTZ J. P., HILL G. J., 2nd NEPHROTOXICITY OF AMPHOTERICIN B; EARLY AND LATE EFFECTS IN 81 PATIENTS. Ann Intern Med. 1964 Aug;61:175–187. doi: 10.7326/0003-4819-61-2-175. [DOI] [PubMed] [Google Scholar]
  3. Bell D. S. Dangers of treatment of status epilepticus with diazepam. Br Med J. 1969 Jan 18;1(5637):159–161. doi: 10.1136/bmj.1.5637.159. [DOI] [PMC free article] [PubMed] [Google Scholar]
  4. Dumonde D. C., Maini R. N. The clinical significance of mediators of cellular immunity. Clin Allergy. 1971 Mar;1(1):123–139. doi: 10.1111/j.1365-2222.1971.tb02453.x. [DOI] [PubMed] [Google Scholar]
  5. Ellis C. A., Spivack M. L. The significance of candidemia. Ann Intern Med. 1967 Sep;67(3):511–522. doi: 10.7326/0003-4819-67-3-511. [DOI] [PubMed] [Google Scholar]
  6. Federlin K., Maini R. N., Russell A. S., Dumonde D. C. A micro-method for peripheral leucocyte migration in tuberculin sensitivity. J Clin Pathol. 1971 Sep;24(6):533–536. doi: 10.1136/jcp.24.6.533. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. Gardner A. J. Withdrawal fits in barbiturate addicts. Lancet. 1967 Aug 12;2(7511):337–338. doi: 10.1016/s0140-6736(67)90174-2. [DOI] [PubMed] [Google Scholar]
  8. Golbert T. M., Sanz C. J., Rose H. D., Leitschuh T. H. Comparative evaluation of treatments of alcohol withdrawal syndromes. JAMA. 1967 Jul 10;201(2):99–102. [PubMed] [Google Scholar]
  9. HABER R. W., JOSEPH M. Neurological manifestations after amphotericin B therapy. Br Med J. 1962 Jan 27;1(5273):230–231. doi: 10.1136/bmj.1.5273.230. [DOI] [PMC free article] [PubMed] [Google Scholar]
  10. HOYER J. R., HOYER L. W., GOOD R. A., CONDIE R. M. The effect of 6-mercaptopurine on delayed hypersensitivity in guinea pigs. J Exp Med. 1962 Nov 1;116:679–685. doi: 10.1084/jem.116.5.679. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. Hoffman T. A., Bullock W. E. Carbenicillin therapy of Pseudomonas and other gram-negative bacillary infections. Ann Intern Med. 1970 Aug;73(2):165–171. doi: 10.7326/0003-4819-73-2-165. [DOI] [PubMed] [Google Scholar]
  12. Kozinn P. J., Taschdjian C. L., Seelig M. S., Caroline L., Teitler A. Diagnosis and therapy of systemic candidiasis. Sabouraudia. 1969 Jun;7(2):98–109. doi: 10.1080/00362177085190181. [DOI] [PubMed] [Google Scholar]
  13. Leger L., Lenriot J. P., Lemaigre G. L'hypertension et la stase portales segmentaires dans les pancréatites chroniques. A propos de 126 cas examinés par spléno-portographie et spléno-manométrie. J Chir (Paris) 1968 May-Jun;95(5):599–608. [PubMed] [Google Scholar]
  14. McCurdy D. K., Frederic M., Elkinton J. R. Renal tubular acidosis due to amphotericin B. N Engl J Med. 1968 Jan 18;278(3):124–130. doi: 10.1056/NEJM196801182780302. [DOI] [PubMed] [Google Scholar]
  15. NEWCOMER V. D., STERNBERG T. H., WRIGHT E. T., REISNER R. M. Current status of amphotericin B in the treatment of the systemic fungus infections. J Chronic Dis. 1959 Apr;9(4):353–374. doi: 10.1016/0021-9681(59)90056-6. [DOI] [PubMed] [Google Scholar]
  16. New P. S., Wells C. E. Cerebral toxicity associated with massive intravenous penicillin therapy. Neurology. 1965 Nov;15(11):1053–1058. doi: 10.1212/wnl.15.11.1053. [DOI] [PubMed] [Google Scholar]
  17. Pepys J., Faux J. A., McCarthy D. S., Hargreave F. E. Candida albicans precipitins in respiratory disease in man. J Allergy. 1968 Jun;41(6):305–318. doi: 10.1016/0021-8707(68)90073-7. [DOI] [PubMed] [Google Scholar]
  18. SCHWARTZ R., DAMESHEK W. The effects of 6-mercaptopurine on homograft reactions. J Clin Invest. 1960 Jun;39:952–958. doi: 10.1172/JCI104116. [DOI] [PMC free article] [PubMed] [Google Scholar]
  19. STAAL A., MECHELSE K., DELEEUW B. NEUROLOGISCHE COMPLICATIE BIJ TOEDIENING VAN EEN FUNGICIED ANTIBIOTICUM. Ned Tijdschr Geneeskd. 1963 Dec 7;107:2276–2277. [PubMed] [Google Scholar]
  20. STALLYBRASS F. C. CANDIDA PRECIPITINS. J Pathol Bacteriol. 1964 Jan;87:89–97. doi: 10.1002/path.1700870113. [DOI] [PubMed] [Google Scholar]
  21. Salter W., Zinneman H. H. Bacteremia and Candida septicemia. Review of 185 cases during a four-year period. Minn Med. 1967 Oct;50(10):1489–1499. [PubMed] [Google Scholar]
  22. Schindler S. C., Schaefer J. W., Hull D., Griffen W. O., Jr Chronic pancreatic ascites. Gastroenterology. 1970 Sep;59(3):453–459. [PubMed] [Google Scholar]
  23. UTZ J. P., TREGER A. The current status of chemotherapy of systemic fungal disease. Ann Intern Med. 1959 Dec;51:1220–1229. doi: 10.7326/0003-4819-51-6-1220. [DOI] [PubMed] [Google Scholar]
  24. VINCE S. Generalized endogenous mycosis in childhood. Med J Aust. 1959 Aug 1;46(2):145–149. doi: 10.5694/j.1326-5377.1959.tb100514.x. [DOI] [PubMed] [Google Scholar]
  25. WINNER H. I. A study of Candida albicans agglutinins in human sera. J Hyg (Lond) 1955 Dec;53(4):509–512. doi: 10.1017/s0022172400001005. [DOI] [PMC free article] [PubMed] [Google Scholar]
  26. ZIMMERMAN L. E. Fatal fungus infections complicating other diseases. Am J Clin Pathol. 1955 Jan;25(1):46–65. doi: 10.1093/ajcp/25.1.46. [DOI] [PubMed] [Google Scholar]

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