Reversible thrombocytosis and anemia due to miconazole therapy

Area of Science:

• Mycology
• Hematology
• Pharmacology

Background:

• Coccidioidal infection is a serious fungal disease.
• Miconazole is an antifungal agent used in treating fungal infections.
• Systemic administration of miconazole can have various side effects.

Purpose of the Study:

• To investigate the hematological effects of intravenous miconazole in patients with active coccidioidal infection.
• To determine if observed hematological abnormalities are dose-related and reversible.

Main Methods:

• Intravenous miconazole administration in six consecutive patients.
• Monitoring of hematological parameters, including anemia and thrombocytosis.
• Bone marrow studies in three subjects to assess erythroid and platelet production.

Main Results:

• Progressive anemia and thrombocytosis were observed in patients receiving miconazole.
• Hematological abnormalities appeared to be dose-dependent.
• Bone marrow findings included erythroid hypoplasia and increased platelet production.
• No hemorrhagic or thrombotic events were reported.

Conclusions:

• Intravenous miconazole therapy for coccidioidal infection can lead to significant hematological abnormalities.
• These abnormalities, including anemia and thrombocytosis, are potentially reversible and dose-related.
• Close hematological monitoring is crucial for patients undergoing systemic miconazole treatment.