Efficacy of Liposomal Amphotericin B in Treating Pulmonary Aspergillus flavus Infection in Nonneutropenic Adults: Cases Report and Literature Review

脂质体两性霉素B治疗非中性粒细胞减少症成人肺部黄曲霉感染的疗效:病例报告和文献综述

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Abstract

Liposomal amphotericin B (L-AmB), as a modified formulation of traditional amphotericin B, have better targeting and lower toxicity. However, clinicians have limited experience with the use of L-AmB for the treatment of Aspergillus flavus (A. flavus) at present. We described two cases of immunocompetent adults; despite undergoing various antibacterial treatments, the symptoms were persistent. Based on the clinical characteristics and results of metagenomic next-generation sequencing and (or) pathology, pulmonary A. flavus infection was confirmed. Subsequently, L-AmB was added to the treatment. Following the initiation of antifungal therapy, the patients' symptoms and images were significantly improved. In conclusion, even in immunocompetent individuals, pathogen detection and pathological examination are crucial when treatment is not effective. In pulmonary A. flavus infection, L-AmB may deserve greater attention and confidence in clinic.

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