AUTHOR=Puertas Sanjuan Adrian , Parramón-Teixidó Carlos Javier , Hernandez-Perez Susana , Frick Marie Antoinette , Cabañas Poy Maria Jose 

TITLE=Persistent dyselectrolytemia in a neonate induced by liposomal amphotericin B. A case report

JOURNAL=Frontiers in Pediatrics

VOLUME=Volume 10 - 2022

YEAR=2023

URL=https://www.frontiersin.org/journals/pediatrics/articles/10.3389/fped.2022.1099305

DOI=10.3389/fped.2022.1099305

ISSN=2296-2360

ABSTRACT=Background
Nephrotoxicity is the most frequent serious adverse effect associated with deoxycholate amphotericin B treatment, for this reason, in recent years it has been relegated from routine clinical practice and replaced by the new liposomal formulations that have less nephrotoxicity. Nevertheless, dyselectrolytemias are a frequent adverse effect of the use of liposomal amphotericin B that usually are resolved with the withdrawal of the drug.

Case presentation
We present a preterm neonate of 25 weeks gestation, with preserved renal function and most electrolytes within normal limits for gestational age except for mild hyponatremia in the first month of life. Due to an infection of the central nervous system and growth of Candida albicans, he required treatment with endovenous liposomal amphotericin B as well as intrathecal deoxycholate amphotericin B showing severe hydroelectrolyte disturbances a few days after starting treatment that persisted over time even after withdrawal of both drugs. In preterm or low birth weight newborns who present unjustified, severe and difficult to correct hydroelectrolyte disturbances despite the usual treatment, a possible tubulopathy should be considered, whether hereditary, primary or secondary to toxins or drugs.

What Is New and Conclusion
We present the first case reported in a neonate in whom dyselectrolithemia has been maintained over time after withdrawal of liposomal amphotericin b.