Abstract: Objective To study the association of gastrointestinal bleeding with amphotericin B cholesteryl sulfate complex for injection(ABCD) and potential mechanisms during the treatment of pulmonary mucormycosis in order to provide references for monitoring of clinical safety. Methods A retrospective analysis was conducted of an elderly patient with invasive pulmonary mucormycosis who had developed gastrointestinal bleeding after receiving ABCD. Such databases as Wanfang, CNKI, and PubMed were searched for reports on adverse reactions related to ABCD. Causality was evaluated using both the criteria stipulated by the National Adverse Drug Reaction Monitoring Center and the Naranjo Adverse Drug Reaction Probability Scale. Results The patient presented with fresh hematochezia on the sixth day of ABCD therapy. Symptoms were resolved after discontinuation of ABCD and hemostatic treatment, with no recurrence. Causality assessment indicated a “probable” association between ABCD and the gastrointestinal bleeding event. Conclusion Although ABCD can reduce the nephrotoxicity associated with conventional amphotericin B, its potential risk of inducing gastrointestinal bleeding warrants attention, particularly in elderly patients with multiple underlying conditions.

Key words: Amphotericin B cholesteryl sulfate complex for Injection, Pulmonary Mucormycosis, Gastrointestinal Bleeding, Elderly Patient, Adverse Drug Reaction