Peripheral eosinophilia and eosinophilic colitis during long‐term azole therapy for pulmonary aspergillosis

Grzegorczyk, Barbara; Murata, Yoshihiko

doi:10.1099/jmmcr.0.004135

Cited by 2 publications

(3 citation statements)

References 8 publications

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“…A study by Grzegorczyk et al evaluated the relationship between VRZ-induced colitis and eosinophilia, which demonstrated a complete resolution of symptoms and normal eosinophil count following cessation of the antifungal agent. [ 12 ]. In another case report by Vishnubhotla et al, patients initially presenting with fever of unknown origin and elevated eosinophils have an improvement in symptoms after stopping the antifungal agent [ 13 ].…”

Section: Discussionmentioning

confidence: 99%

Voriconazole Induced Cutaneous Squamous Cell Carcinoma in an Immunocompetent Patient

Parza¹,

Singh²,

Cvinar³

et al. 2022

Cureus

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Voriconazole therapy can be associated with hair loss, vision changes, and skin phototoxicity, but rarely is it associated with the development of skin cancer. We present a case of an immunocompetent 42-year-old Caucasian male with a past medical history significant for chronic pulmonary aspergillosis (CPA) and prior cutaneous squamous cell carcinoma (cSCC) of the left hand who arrived at our clinic for evaluation of an enlarging, non-tender left preauricular mass over the past six months. He had diffuse actinic changes and appeared older relative to his age. He had a fair complexion but was compliant with sun protection measures and minimized unnecessary ultraviolet (UV) light exposure. His left-sided facial mass was excised, and the final pathology was consistent with cSCC. His only home medication was oral voriconazole 200 mg once daily for six years for pulmonary aspergillosis. He was negative for human immunodeficiency virus (HIV) and had no history of prior transplant operations. This case highlights the importance of recognizing voriconazole as an independent risk factor in the development of cSCC, especially in patients on chronic therapy for aspergillosis.

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Section: Discussionmentioning

confidence: 99%

Voriconazole Induced Cutaneous Squamous Cell Carcinoma in an Immunocompetent Patient

Parza¹,

Singh²,

Cvinar³

et al. 2022

Cureus

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show abstract

“…Subsequently in 2014, Grzegorczyk et al . published a case of a patient with chronic pulmonary aspergillosis who presented with peripheral eosinophilia and eosinophilic colitis after more than 5 years of treatment with voriconazole [ 7 ]. The eosinophilia and associated gastrointestinal symptoms resolved after stopping voriconazole.…”

Section: Discussionmentioning

confidence: 99%

“…The eosinophilia and associated gastrointestinal symptoms resolved after stopping voriconazole. The patient subsequently had a recurrence of the eosinophilia and diarrhoea after 15 months of posaconazole treatment [ 7 ]. Symptomatic improvement was again documented with discontinuation of azole therapy.…”

Section: Discussionmentioning

confidence: 99%

Marked peripheral eosinophilia due to prolonged administration of posaconazole

et al. 2017

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Introduction. Posaconazole is a triazole antifungal that is used in the treatment of a variety of fungal infections, as well as in the management of mucormycosis (on an off-label basis). Eosinophilia associated with exposure to azole antifungals has been described rarely in the literature. Case presentation. A 31-year-old male on peritoneal dialysis (PD) for end-stage renal disease, secondary to diabetic nephropathy, presented to hospital with abdominal pain after a trip to St Lucia. He was taken to the operating room, where the PD catheter was removed and an abdominal-wall abscess was debrided. R hizopus species was recovered on culture of the abdominal-wall tissue, and the patient was started on amphotericin B deoxycholate. He was subsequently stepped down to posaconazole, for a planned treatment duration of 12 months. Approximately 43 days after the initiation of posaconazole, it was noted that his peripheral eosinophil count started to rise. No other cause for the eosinophilia was identified. Posaconazole was discontinued, and the patient’s eosinophil count began to drop 2 days later. The temporal association of eosinophilia following initiation of posaconazole and the subsequent improvement after drug discontinuation suggests a probable causal relationship. Conclusion. At the time of writing, there have been only two other published cases of azole-associated peripheral eosinophilia. In reporting this case, we hope to increase health-care provider awareness of this rare adverse event. For patients receiving prolonged therapy with posaconazole, periodic monitoring of the complete blood count with differential may be considered.

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Peripheral eosinophilia and eosinophilic colitis during long‐term azole therapy for pulmonary aspergillosis

Cited by 2 publications

References 8 publications

Voriconazole Induced Cutaneous Squamous Cell Carcinoma in an Immunocompetent Patient

Voriconazole Induced Cutaneous Squamous Cell Carcinoma in an Immunocompetent Patient

Marked peripheral eosinophilia due to prolonged administration of posaconazole

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