Key result
Liposomal amphotericin B administration in a 9-month-old girl was associated with repeated episodes of bradycardia and second-degree atrioventricular block, which resolved 8 days after drug suspension.
Case Report (n=1)
Liposomal amphotericin B may cause reversible second-degree atrioventricular block as a rare cardiotoxic adverse effect.
May signal rare reversible AV block risk in infants on liposomal amphotericin B; leaves open causality and need for systematic study.
Atrioventricular block can occur in normal children, young adults or athletes. It is also associated with underlying heart disease or occurs as a drug adverse effect. Amphotericin B is used in the treatment of invasive fungal infections. Cardiac toxicity is a rare adverse reaction. We report the case of a 9-month girl, admitted in the paediatric intensive care unit with cytomegalovirus pneumonitis. During hospitalisation the patient developed a systemic fungic infection and was medicated with liposomal amphotericin B. On the third day of treatment she began repeated episodes of bradycardia with spontaneous reversion. The investigation revealed a second-degree atrioventricular block. We excluded the misplacement of the central catheter, myocarditis or structural cardiomyopathy and suspended amphotericin. After 8 days, the bradycardia episodes ceased what was consistent with the drug's half-life. Amphotericin cardiotoxic mechanism is still unclear. It may be related with alteration of myocardial membrane depolarisation.
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Sanches et al. (2014) conducted a case report in Systemic fungal infection (n=1). Liposomal amphotericin B was evaluated on Second-degree atrioventricular block. Liposomal amphotericin B administration in a 9-month-old girl was associated with repeated episodes of bradycardia and second-degree atrioventricular block, which resolved 8 days after drug suspension.
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