CASE REPORT article
Front. Med.
Sec. Infectious Diseases: Pathogenesis and Therapy
Volume 12 - 2025 | doi: 10.3389/fmed.2025.1697842
This article is part of the Research TopicPathogenic microorganisms and biosafetyView all 22 articles
Successful Ventilator Weaning After Aerosolized Liposomal Amphotericin B in Persistent Candida glabrata Colonization: A Case Report
Provisionally accepted
Massimo Caracciolo1*
Simona Pellicano1Sarah Antonella Caracciolo2Maria Francesca Stagno1Antonino Ripepi1Selma Valerie Mammone3Nadia Pellicano1Stefano La Scala1Giuseppe Mazza4Giuseppe Neri4- 1Grande Ospedale Metropolitano Bianchi-Melacrino-Morelli, Reggio Calabria, Italy
- 2Universita degli Studi di Siena, Siena, Italy
- 3Casa di Cura Humanitas San Pio X, Milan, Italy
- 4Universita degli Studi Magna Graecia di Catanzaro, Catanzaro, Italy
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Background: Invasive candidiasis and persistent fungal colonization of the airways are increasingly recognized as potential barriers to successful weaning from mechanical ventilation in critically ill patients. Among non-albicans Candida species, Candida glabrata, recently reclassified as Nakaseomyces glabrata, is particularly challenging due to its unique mechanisms of resistance and immune evasion. The use of aerosolized liposomal amphotericin B (Ambisome®) offers a promising local therapeutic approach, combining targeted delivery with a favorable safety profile. Case Presentation: We present the case of a 68-year-old man who required prolonged mechanical ventilation following an ischemic stroke and subsequently developed persistent bronchial colonization by Candida glabrata. Despite systemic antifungal therapy, the colonization persisted, and pulmonary compliance remained poor. The administration of aerosolized liposomal amphotericin B (10 mg BID for 10 days) led to significant improvement in respiratory mechanics and allowed for successful weaning from the ventilator. Follow-up cultures confirmed microbiological clearance. Conclusion: This case highlights the potential role of aerosolized liposomal amphotericin B as an effective and well-tolerated treatment for persistent fungal airway colonization by C. glabrata, even in non-immunocompromised ICU patients.
Keywords: Aerosolized amphotericin B, Candida glabrata Nakaseomyces glabrata, Ventilator Weaning, ICU, Liposomal formulation, Aerogen vibrating mesh device, Immune Evasion, fungal colonization
Received: 02 Sep 2025; Accepted: 23 Oct 2025.
Copyright: © 2025 Caracciolo, Pellicano, Caracciolo, Stagno, Ripepi, Mammone, Pellicano, La Scala, Mazza and Neri. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Massimo Caracciolo, maxcar673@gmail.com
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