Management of Amphotericin-B deoxycholate-Induced Hypokalemia : A Case Report

Abstract

          Amphotericin B deoxycholate (AmB-d) is a first line therapy for cryptococcal meningitis in both immunocompetent and immunocompromised patients. Common adverse events from AmB-d are acute kidney injury and electrolyte imbalance especially hypokalemia. But these adverse events can prevent or alleviate when giving patients adequate fluids and electrolyte supplementation. Hypokalemia may lead to severe cardiological or musculoskeletal complication. Since 2018, the World Health Organization (WHO) recommends prehydration and early potassium supplementation during AmB-d use, but not quite acceptable due to limited of clinical study. In this case study, a 46 years old Thai male came to the hospital with slurred speech, headache, double vision, did not have any accident, no underlying disease. He worked at a sawmill for 10 years. The brain scan showed no evidence of cerebral ischemia or hemorrhage. Until the cryptococcal antigen titer test revealed abnormality, physician diagnosed the cryptococcal meningitis. AmB-d and flucytosine were started. He received early oral potassium supplementation until potassium level normalized.