1887

Abstract

Introduction:

Voriconazole and posaconazole are often used to treat invasive infections. We describe a patient with chronic pulmonary aspergillosis (CPA) who experienced peripheral eosinophilia and eosinophilic colitis while on voriconazole, and also experienced gastrointestinal symptoms and recurrent eosinophilia while on subsequent posaconazole therapy.

Case presentation:

A 75‐year‐old female with recurrent pulmonary mucus plugs due to CPA was treated with long‐term oral voriconazole. The patient had no clinical evidence of CPA exacerbations while on such antifungal treatment but developed peripheral eosinophilia, diarrhoea and eosinophilic colitis after >5 years of voriconazole therapy that resolved after cessation of azole therapy. Due to a CPA exacerbation after stopping voriconazole, the patient was started on posaconazole as an alternative CPA therapy. However, after 15 months, the patient developed a recurrence of peripheral eosinophilia and diarrhoea while on posaconazole.

Conclusion:

Long‐term use of voriconazole and posaconazole can be used successfully to reduce the incidence of CPA exacerbations. However, such antifungal therapy may also lead to peripheral eosinophilia, diarrhoea and eosinophilic colitis.

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/content/journal/jmmcr/10.1099/jmmcr.0.004135
2014-12-01
2019-10-22
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References

  1. Al‐shair K. , Atherton G.T. , Harris C. , Ratcliffe L. , Newton P.J. , Denning D.W. . ( 2013; ). Long‐term antifungal treatment improves health status in patients with chronic pulmonary aspergillosis: a longitudinal analysis. . Clin Infect Dis 57:, 828–835.[CrossRef]
    [Google Scholar]
  2. Kousha M. , Tadi R. , Soubani A.O. . ( 2011; ). Pulmonary aspergillosis: a clinical review. . Eur Respir Rev 20:, 156–174.[CrossRef]
    [Google Scholar]
  3. Lestner J. , Hope W.W. . ( 2013; ). Itraconazole: an update on pharmacology and clinical use for treatment of invasive and allergic fungal infections. . Expert Opin Drug Metab Toxicol 9:, 911–926.[CrossRef]
    [Google Scholar]
  4. Nagappan V. , Deresinski S. . ( 2007; ). Posaconazole: a broad‐spectrum triazole antifungal agent. . Clin Infect Dis 45:, 1610–1617.[CrossRef]
    [Google Scholar]
  5. Naranjo C.A. , Busto U. , Sellers E.M. , Sandor P. , Ruiz I. , Roberts E.A. , Janecek E. , Domecq C. , Greenblatt D.J. . ( 1981; ). A method for estimating the probability of adverse drug reactions. . Clin Pharmacol Ther 30:, 239–245.[CrossRef]
    [Google Scholar]
  6. Sambatakou H. , Dupont B. , Lode H. , Denning D.W. . ( 2006; ). Voriconazole treatment for subacute invasive and chronic pulmonary aspergillosis. . Am J Med 119:, 17–24.[CrossRef]
    [Google Scholar]
  7. Saravolatz L.D. , Johnson L.B. , Kauffman C.A. . ( 2003; ). Voriconazole: a new triazole antifungal agent. . Clin Infect Dis 36:, 630–637.[CrossRef]
    [Google Scholar]
  8. Vishnubhotla P. , Ibrahim R.B. , Abidi M.H. , Chandrasekar P.H. . ( 2004; ). Fever and eosinophilia associated with voriconazole. . Ann Pharmacother 38:, 900–901.[CrossRef]
    [Google Scholar]
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