Successful ventilator weaning after aerosolized liposomal amphotericin B in persistent Candida glabrata colonization: a case report

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.