A Case Report of Amphotericin B-Induced Recurrent Hypokalemia Complicating Cryptococcal Meningoencephalitis in a HIV Patient

Cryptococcal meningoencephalitis is a severe opportunistic infection in people with HIV. We report a 42-year-old man presenting with significant weight loss, neurological symptoms, and progressive vomiting. Neuroimaging and positive cryptococcal antigen testing in cerebrospinal fluid confirmed the diagnosis. The patient’s neurological condition gradually improved after receiving induction therapy with intravenous amphotericin B and high-dose fluconazole. The course was exacerbated by recurring severe hypokalemia linked to amphotericin B, which necessitated vigilant cardiac and electrolyte monitoring as well as rigorous potassium supplementation. Notably, rather than stopping amphotericin B treatment in spite of significant hypokalemia, it was carefully corrected and monitored. This instance illustrates the significance of careful monitoring and prompt management of metabolic abnormalities in patients with advanced HIV infection by highlighting the concurrent challenge of managing a life-threatening fungal infection while addressing treatment-related toxicity.