Isavuconazole-induced Acute Liver Failure in a Pediatric Patient With Invasive Aspergillosis

Area of Science:

• Mycology
• Pharmacology
• Pediatric Medicine

Background:

• Isavuconazole is an azole antifungal agent.
• It is approved for adults with invasive aspergillosis and mucormycosis.
• Phase III trials reported favorable hepatic tolerability.

Observation:

• A pediatric patient underwent bone marrow transplantation.
• The patient received isavuconazole for invasive aspergillosis.
• The patient developed severe liver injury during treatment.

Findings:

• A case of drug-induced liver failure attributed to isavuconazole was observed.
• This adverse event occurred in a pediatric patient post-bone marrow transplant.
• The findings contrast with the generally favorable hepatic safety profile reported in adult trials.

Implications:

• This case underscores the importance of vigilant liver function monitoring in pediatric patients receiving isavuconazole.
• It suggests a potential for idiosyncratic drug-induced liver injury with isavuconazole in younger populations.
• Further investigation into the pharmacokinetics and pharmacodynamics of isavuconazole in pediatric patients may be warranted.