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Updated: Jun 15, 2026
07:40
A Model of Self-limited Acute Lung Injury by Unilateral Intra-bronchial Acid Instillation
Published on: August 30, 2019
Diffuse alveolar hemorrhage following itraconazole injection
Koichi Izumikawa1, Ken Nakano, Shintaro Kurihara
1The Second Department of Internal Medicine, Nagasaki University School of Medicine. koizumik@nagasaki-u.ac.jp
Internal Medicine (Tokyo, Japan)
|March 2, 2010
Summary
Diffuse alveolar hemorrhage (DAH) is a severe condition. A case report suggests intravenous itraconazole (ITCZ) may induce DAH, with polymyxin B hemoperfusion showing promising therapeutic effects.
Area of Science:
- Pulmonology
- Toxicology
- Critical Care Medicine
Background:
- Diffuse alveolar hemorrhage (DAH) is a life-threatening condition with various potential causes.
- Chronic pulmonary aspergillosis requires management, sometimes involving antifungal agents like itraconazole.
Observation:
- A 53-year-old male developed DAH post-pneumonectomy.
- Intravenous itraconazole (ITCZ) was administered for chronic pulmonary aspergillosis.
- Standard diagnostic workups excluded other etiologies for DAH.
Findings:
- DAH was diagnosed via bronchoalveolar lavage.
- A positive drug lymphocyte stimulation test suggested ITCZ as the etiological factor.
- The patient showed no response to pulse methylprednisolone.
Implications:
- Intravenous ITCZ is a potential, albeit rare, cause of DAH.
- Polymyxin B-immobilized fiber column (PMX) hemoperfusion offers a novel therapeutic option for ITCZ-induced DAH.
- This case highlights the importance of considering drug-induced DAH and alternative treatment strategies.
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