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Voriconazole-Induced acute interstitial pulmonary edema with angioedema: A case report
Yuzhen Jin1, Lijie Qin1, Peng Liu1
1Department of Respiratory and Critical Care Medicine, Cangzhou Fifth Hospital (People's Hospital of Qingxian), Cangzhou, China.
Background:
Voriconazole is a first-line antifungal agent for invasive fungal infections. Reports of voriconazole-induced interstitial pulmonary edema are exceedingly rare.
Case Presentation:
We describe a 74-year-old woman with pneumonia who developed facial edema, dyspnea, and pink frothy sputum after four days of voriconazole therapy. Chest computed tomography (CT) revealed bilateral pleural effusions and interlobular septal thickening. She was initially misdiagnosed with acute heart failure, but failed to respond to diuretics. Both B-type natriuretic peptide (BNP) levels and echocardiography were unremarkable. The diagnosis of voriconazole-induced acute interstitial pulmonary edema was established. Voriconazole withdrawal and corticosteroid therapy resulted in rapid clinical resolution.
Conclusion:
Voriconazole hypersensitivity may manifest as acute interstitial pulmonary edema with concomitant angioedema, a presentation that can mimic cardiogenic pulmonary edema. Early recognition and timely corticosteroid intervention are crucial for favorable outcomes.
Insights
Voriconazole can rarely cause acute interstitial pulmonary edema and angioedema. Promptly stopping the medication and using corticosteroids led to rapid recovery in a patient with pneumonia.
Area of Science:
- Medicine
- Pulmonology
- Pharmacology
Background:
- Voriconazole is a key antifungal for invasive infections.
- Voriconazole-induced interstitial pulmonary edema is a rare adverse event.
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