Abstract: Objective To analyze the nervous system toxicity induced by amphotericin B liposomes delivered by intrathecal injection in a patient with pediatric cryptococcal meningitis in order to help reduce adverse reactions in pediatrics. Methods Data on the patient's process of hospitalization, therapeutic regimen, time of occurrence and prognosis of adverse reactions was collected. The related literature and diagnosis and treatment guidelines were reviewed, possible causes of adverse reactions were analyzed and corresponding treatment measures were recommended. Results It was likely that the adverse reactions were caused by the intrathecal injection of amphotericin B liposomes. After discontinuation of intrathecal injection and psychological counseling, the adverse reactions were relieved. Conclusion There is a high risk of neurotoxic reactions when amphotericin B is administrated by intrathecal injection, so intrathecal injection should not be routinely recommended for cases of non-refractory cryptococcal meningitis. Amphotericin B liposomes should be avoided when intrathecal injection is needed. Given the weak psychological capacity of pediatric patients, appropriate psychological counseling could optimize the treatment response.

Key words: amphotericin B liposomes, intrathecal injection, nervous system toxicity