Itraconazole
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Pleural effusion: case report A 64-year-old woman developed pleural effusion during treatment with itraconazole. The woman was admitted with a two-week history of dyspnea upon exertion. She had a history of asthma and histoplasmosis, and had been receiving treatment with itraconazole [route and dosage not stated]. Upon admission, a chest CT showed bilateral pleural effusions greater on the right side. It was concluded that the pleural effusion was not related to the histoplasmosis, as the repeat chest CT scan showed that the pulmonary granuloma had decreased in size since itraconazole initiation. The woman’s itraconazole therapy was discontinued as her therapy was almost complete. She underwent thoracentesis and 1200cc fluid was removed from the right side. Fluid analysis showed lymphocytic predominant exudative effusion, which was negative for cultures and cytology. Her symptoms showed significant improvement following thoracentesis. She was discharged without anti-fungal therapy. At a follow-up two weeks later, ultrasound showed small right-sided pleural effusion, but she denied the presence of symptoms. Therefore it was decided to treat her conservatively and further thoracentesis was discontinued. For the next 6 months, her condition was well and she had no recurrent complaints Dhingra M, et al. Antifungal fallout: Pleural effusion caused by itraconazole therapy. American Journal of Respiratory and Critical Care Medicine 199: abstr. A6430, No. 9, 803447029 May 2019. Available from: URL: https://www.atsjournals.org/doi/abs/10.1164/ajrccm-conference.2019.199.1_MeetingAbstracts.A6430 [abstract]
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Reactions 18 Jan 2020 No. 1787
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