| Salvage treatment with amphotericin B in progressive human alveolar echinococcosis. | |
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MedLine Citation:
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PMID: 14576122 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Most patients with alveolar echinococcosis are diagnosed at a late stage when the disease has advanced to unresectable hepatic lesions. These patients require lifelong therapy with benzimidazoles, the only medical treatment currently available. To date, no treatment option remains for patients with benzimidazole intolerance or treatment failure. Amphotericin B was recently shown to exert antiparasitic activity in vitro. Here, we report the efficacy of amphotericin B in human alveolar echinococcosis. In three patients with extensive disease and without further treatment options, disease progression had been documented over several months. They were treated with amphotericin B intravenously at a dose of 0.5 mg/kg of body weight three times per week. Follow-up parameters were physical examination, laboratory parameters, and imaging techniques. Amphotericin B treatment effectively halted parasite growth in all three patients. The antiparasitic effect was most evident by spontaneous closure of cutaneous fistulae in two patients and by constant size of parasitic lesions during treatment, as assessed radiologically. Metabolic activity in parasitic areas was visualized by positron emission tomography and significantly decreased during treatment. However, progressive affection of the heart in one patient could not be stopped. All patients currently continue on amphotericin B and have been treated for 25, 17, and 14 months, respectively. We introduce amphotericin B as salvage treatment for alveolar echinococcosis patients with intolerance or resistance to benzimidazoles, as it effectively suppresses parasite growth. Amphotericin B is not parasitocidal; therefore long-term treatment has to be anticipated. |
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Authors:
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Stefan Reuter; Andreas Buck; Olaf Grebe; Karin Nüssle-Kügele; Peter Kern; Burkhard J Manfras |
Publication Detail:
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Type: Case Reports; Journal Article |
Journal Detail:
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Title: Antimicrobial agents and chemotherapy Volume: 47 ISSN: 0066-4804 ISO Abbreviation: Antimicrob. Agents Chemother. Publication Date: 2003 Nov |
Date Detail:
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Created Date: 2003-10-24 Completed Date: 2004-07-06 Revised Date: 2013-04-18 |
Medline Journal Info:
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Nlm Unique ID: 0315061 Medline TA: Antimicrob Agents Chemother Country: United States |
Other Details:
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Languages: eng Pagination: 3586-91 Citation Subset: IM |
Affiliation:
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Section of Infectious Diseases and Clinical Immunology, Department of Medicine III, University Hospital of Ulm, Ulm, Germany. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adolescent Aged Amphotericin B / therapeutic use* Animals Antiprotozoal Agents / therapeutic use* Echinococcosis, Hepatic / drug therapy*, parasitology Echinococcosis, Pulmonary / drug therapy*, parasitology Echinococcus / growth & development Female Fluorodeoxyglucose F18 / diagnostic use Gerbillinae Humans Long-Term Care Magnetic Resonance Imaging Male Radiopharmaceuticals / diagnostic use Salvage Therapy* Tomography, Emission-Computed Tomography, X-Ray Computed |
| Chemical | |
Reg. No./Substance:
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0/Antiprotozoal Agents; 0/Radiopharmaceuticals; 1397-89-3/Amphotericin B; 63503-12-8/Fluorodeoxyglucose F18 |
| Comments/Corrections | |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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