AMPHOTERICIN B-ASSOCIATED HYPERTENSION

OBJECTIVE: TO report two cases of hypertension related to amphotericin B infusion, CASE SUMMARY: A 63-year-old woman with Candida albicans b acteremia and an 84-year-old man with Aspergillus fumigatus pneumonia developed hypertension within minutes of amphotericin B administration . Both patients' blood pressure returned to baseline soon after the in fusion of amphotericin B was stopped, Neither patient was rechallenged . DISCUSSION: A causal relationship may exist between the administrati on of amphotericin B and these hypertensive episodes. Blood pressure i n both patients normalized without treatment on discontinuation of the infusion. The mechanism of amphotericin B-associated hypertension is unclear but could include vasoconstricting properties of the drug or t he administration of intravenous NaCl 0.9% prior to amphotericin B inf usion. We recommend that intravenous NaCl 0.9% be administered followi ng amphotericin B infusion and that the infusion be stopped if hyperte nsive episodes arise, CONCLUSIONS: Both acute hypertension and hypoten sion can occur in patients receiving amphotericin B for systemic funga l infections.