Accoutumance à l'ambisome

The authors describe a case of severe Fusarium solani mycose non responsive to either azol derivatives or to the classical form of amphotericin B. The patient was treated with Ambisome (liposomal amphotericin). The first infusion induced a shock and an angioneurotic oedema within 10 minutes. The authors stress the need to: 1) thoroughly interrogate the patient in order to obtain a perfect description of the symptoms and the circumstances of their happening; 2) measure the tryptase level, perform a prick test with Ambisome, in order to differentiate an anaphylactic from an anaphylactoid shock. In this particular case, and for ten other patients non allergic to Ambisome, the test proved negative. A desensitization procedure with a slow and progressive increase of the doses was performed. It was well tolerated.