# Successful desensitization to liposomal amphotericin B for the treatment of disseminated cryptococcosis in pregnancy: a case report

## TL;DR

A pregnant woman with HIV and cryptococcosis successfully underwent desensitization to a key antifungal drug, enabling continued treatment during pregnancy.

## Contribution

Demonstrates the first successful desensitization to liposomal amphotericin B during pregnancy for treating cryptococcosis.

## Key findings

- A pregnant woman with HIV and cryptococcosis experienced a life-threatening reaction to liposomal amphotericin B.
- A desensitization protocol allowed safe continuation of the drug during pregnancy.
- The case highlights the feasibility of managing cryptococcosis in pregnancy despite limited and potentially harmful treatment options.

## Abstract

Cryptococcosis is the most common opportunistic fungal infection in people with human immunodeficiency virus. On a global scale, it causes 15% of acquired immunodeficiency syndrome-related mortality.

We report the case of a 21-year-old cisgender pregnant woman living with human immunodeficiency virus who presented with headache and photophobia. Her clinical course was complicated by recurrent hospital admissions for disseminated cryptococcosis and a life-threatening reaction to liposomal amphotericin B, the mainstay of treatment. A desensitization protocol was implemented, allowing for continuation of therapy during pregnancy.

The management of cryptococcosis in pregnancy is challenging due to the potential teratogenic effects of antifungals used and the limited therapeutic options available. This case highlights the complexities of treatment in pregnancy and demonstrates successful desensitization to liposomal amphotericin B during pregnancy.