Table 2.
Miltefosine levels in the cerebrospinal fluid and serum of a patient with Balamuthia mandrillaris granulomatous amebic encephalitis, United States, 2010
| Specimen Type | Collection Date (Hospital Admission Day) | Days After Initiation of Miltefosine Treatment a | Miltefosine Concentration (μg/mL) b |
|---|---|---|---|
| CSF | Day 6 | −1 | 0 (<LOD) c |
| CSF | Day 6 | −1 | 0 (<LOD) c |
| CSF | Day 12 | 5 | 0.4 |
| Serum | Day 37 | 30 (about 80 hours after last dose) | 15.3 d |
a
First dose of miltefosine (50 mg twice daily) administered on Day 7 and last dose administered on Day 34.
b
Analyzed on API365 LC-MS/MS equipment; dilution of CSF and sample pretreatment using phenyl-based solid phase reaction.
c
LOD = Limit of detection; not determined for miltefosine in CSF but is probably below 20 ng/mL.
d
At this time, patient had developed acute renal insufficiency (creatinine 4.2 mg/dL, BUN 87 mg/dL) and pancreatitis presumed to be due to pentamidine.