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Deoxycholate amphotericin for histoplasmosis in a patient with poor kidney function
  1. Gokul Krishnan1,
  2. Nitin Gupta2,
  3. Kavitha Saravu3,
  4. Handattu Manjunath Hande1 and
  5. Ruchee Khanna4
  1. 1General Medicine, Kasturba Medical College Manipal, Manipal, Karnataka, India
  2. 2Infectious Diseases, Kasturba Medical College Manipal, Manipal, Karnataka, India
  3. 3Department of Infectious Diseases, Kasturba Medical College Manipal, Manipal, Karnataka, India
  4. 4Department of Pathology, Kasturba Medical College, Manipal, India
  1. Correspondence to Gokul Krishnan; gokulkrishnan8394{at}


A 48-year-old male patient living with HIV presented to our hospital with fever and weight loss. On evaluation, he was found to have pancytopenia, deranged liver and kidney function. CD4 count was 13 cells/uL. Bone marrow examination done because of pancytopenia showed yeast forms of histoplasmosis. Although liposomal amphotericin B is preferred for induction, he was treated with deoxycholate amphotericin B despite poor kidney function because of financial constraints. He was treated for 12 days with intravenous amphotericin, during which his clinical condition significantly improved. He was discharged on oral itraconazole.

  • HIV / AIDS
  • contraindications and precautions
  • acute renal failure

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  • Contributors GK and NG drafted the article. NG and KS were involved in critical revision of article. HMH was the treating physician and performed editing of manuscript. RK helped in drafting of sections on investigations and differential diagnosis

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.