Presentation
The presented case shows one of the multiple issues concerning migration between neighboring countries. [ncbi.nlm.nih.gov]
Entire Body System
- Congestive Heart Failure
At least three of our seven subjects developed either congestive heart failure or hypertension while receiving 400 mg itraconazole, daily. [erj.ersjournals.com]
CARDIAC RISKS FDA believes that there is a small but real risk of developing congestive heart failure associated with Sporanox® therapy. [web.archive.org]
Evidence supporting the association between itraconazole and the onset of congestive heart failure (CHF) is limited and is based on cases reported after drug market release. [ncbi.nlm.nih.gov]
Do not take itraconazole for fungal nail infections if you have had heart failure, including congestive heart failure. [rxwiki.com]
- Swelling
Abstract A 29-year-old woman with swelling, multiple nodules and discharging sinuses of her right foot is presented. [ncbi.nlm.nih.gov]
Check with your doctor right away if you are having more than one of these symptoms: stomach pain or tenderness, clay-colored stools, dark urine, decreased appetite, fever, headache, itching, loss of appetite, nausea, vomiting, skin rash, swelling of [mayoclinic.org]
Swelling. Very bad and sometimes deadly liver problems have rarely happened with this drug. Sometimes this happened within 7 days of starting this drug. [mskcc.org]
Side Effects and Drug Reactions Itraconazole may result in these side effects: Vomiting Swelling of the limbs Loss of appetite Lethargy Itraconazole may react with these drugs: Anticoagulants Antidiabetics Aminophylline Cisapride Cyclosporine Digoxin [petmd.com]
- Fatigue
Symptoms of heart failure include fatigue, edema (fluid retention), shortness of breath, nausea, abdominal pain, and inability to sleep unless sitting upright. [medicinenet.com]
Common toxicities included fatigue, nausea, anorexia, rash, and a syndrome of hypokalemia, hypertension, and edema. [ncbi.nlm.nih.gov]
Alcohol consumption: toxic reaction, hepatic damage Patient monitoring • In patient with hepatic dysfunction, monitor hepatic enzyme levels. ☞ Monitor for signs and symptoms of hearing loss, pancreatitis, hepatic dysfunction (jaundice, fatigue, nausea [medical-dictionary.thefreedictionary.com]
Itraconazole treatment was associated with two adverse events (grade 2 fatigue and grade 4 congestive heart failure). [jco.ascopubs.org]
- Weight Gain
[…] awkwardness unusual bleeding or bruising unusual weight gain or loss upper right abdominal or stomach pain weakness in the arms, hands, legs, or feet Some side effects of itraconazole may occur that usually do not need medical attention. [drugs.com]
gain, swelling ankles or feet or feeling very tired Tell your doctor immediately or ring HealthLine 0800 611 116 Signs of problems with your liver such as yellowing of the skin or eyes, dark urine, pain in the abdomen Tell your doctor immediately or [healthnavigator.org.nz]
Stop using itraconazole and call your doctor at once if you have signs of congestive heart failure: feeling tired or short of breath, cough with mucus, fast heartbeats, swelling, rapid weight gain, or sleep problems. [rxlist.com]
- Intravenous Administration
In the modified antifungal therapy, intravenous administration of itraconazole was replaced by oral administration of voriconazole 200 mg twice daily. Shock did not recur after discontinuation of itraconazole treatment. [ncbi.nlm.nih.gov]
Heart failure: Negative inotropic effects have been observed following intravenous administration. Discontinue or reassess use if signs or symptoms of heart failure (HF) occur during treatment. [mims.com]
The rapid intravenous administration, insufficient dilution and drug vehicle have been associated with the dysrhythmias caused by imidazole antifungals. [jmedicalcasereports.com]
Itraconazole mean total plasma clearance following intravenous administration is 278 mL/min. Itraconazole clearance decreases at higher doses due to saturable hepatic metabolism. Absorption Itraconazole is rapidly absorbed after oral administration. [drugs.com]
Respiratoric
- Sore Throat
throat stomach cramps or pain sweating swelling of the fingers, hands, feet, or lower legs tightness in the chest trembling troubled breathing at rest unpleasant breath odor vomiting of blood weight gain yellow eyes or skin Rare Black, tarry stools bleeding [drugs.com]
If you have thrush in the mouth or throat, place 10 milliliters (mL) of the liquid in your mouth, swish for several seconds, then swallow. Repeat these steps if your total dose is more than 10 mL. [mayoclinic.org]
Elevated liver function tests, insomnia, dizziness, breathlessness, sore throat or cough are rare. Before starting abacavir, a test for the HLA-B*5701 allele is strongly recommended. HLA testing reduces the HSR risk considerably, but not completely. [hivbook.com]
Gastrointestinal
- Nausea
Nausea / vomiting, diarrhea, headache, stomach upset, or dizziness may occur. If any of these effects last or get worse, tell your doctor or pharmacist promptly. [webmd.com]
Symptoms of heart failure include fatigue, edema (fluid retention), shortness of breath, nausea, abdominal pain, and inability to sleep unless sitting upright. [medicinenet.com]
>10% Systemic fungal infections Nausea (11%) 1-10% (Systemic fungal infections) Rash (9%) Vomiting (5%) Edema (4%) Headache (4%) Abnormal liver function test results (3%) Diarrhea (3%) Fever (3%) Fatigue (3%) Hypertension (3%) Pruritus (3%) Abdominal [reference.medscape.com]
- Abdominal Pain
(8%) Sinusitis, injury (7%) Diarrhea (4%) Dyspepsia (4%) Flatulence (4%) Abdominal pain (4%) Dizziness (4%) Rash (4%) Elevated liver enzymes (4%) Gastrointestinal disorders (4%) Rash (3%) Cystitis (3%) Urinary tract infection (3%) Liver function abnormality [reference.medscape.com]
Table 3: Clinical Trials of Systemic Fungal Infections: Adverse Events Occurring with an Incidence of Greater than or Equal to 1% Body System/Adverse Event Incidence (%) (N=602) Gastrointestinal Nausea 11 Vomiting 5 Diarrhea 3 Abdominal Pain 2 Anorexia [rxlist.com]
Tell your doctor right away if you develop symptoms of liver disease, such as: nausea / vomiting that doesn't stop, loss of appetite, stomach / abdominal pain, yellowing eyes / skin, dark urine. [webmd.com]
She had no headache, visual disturbance, abdominal pain, nausea, vomiting, or collapse. Her medication included Seretide 250 Evohaler (fluticasone 250 µg and salmeterol 25 µg) one puff twice daily for four years and inhaled Salbutamol. [bmj.com]
Cardiovascular
- Hypertension
We describe a case of apparent mineralocorticoid excess (hypertension, hypokalemia, metabolic alkalosis and low plasma renin activity) secondary to itraconazole therapy. [ncbi.nlm.nih.gov]
>10% Systemic fungal infections Nausea (11%) 1-10% (Systemic fungal infections) Rash (9%) Vomiting (5%) Edema (4%) Headache (4%) Abnormal liver function test results (3%) Diarrhea (3%) Fever (3%) Fatigue (3%) Hypertension (3%) Pruritus (3%) Abdominal [reference.medscape.com]
At least three of our seven subjects developed either congestive heart failure or hypertension while receiving 400 mg itraconazole, daily. [erj.ersjournals.com]
- Hypotension
To report a rare but severe adverse effect of intravenous itraconazole, anaphylactic shock with hypotension and hypoxemia, in a female patient with acute lymphoblastic leukemia (ALL). [ncbi.nlm.nih.gov]
This hypotensive episode was considered septic, as no other apparent cause was identified. [jmedicalcasereports.com]
Events Leading to Temporary or Permanent Discontinuation of Therapy Adverse Event Incidence (%) Itraconazole (N=112) Elevated Liver Enzymes (greater than twice the upper limit of normal) 4 Gastrointestinal Disorders 4 Rash 3 Hypertension 2 Orthostatic Hypotension [rxlist.com]
[…] hyperkalemia, hypomagnesemia Psychiatric disorders: Confusional state Renal and urinary disorders: Renal impairment Respiratory, thoracic and mediastinal disorders: Dysphonia, cough Skin and subcutaneous tissue disorders: Hyperhidrosis Vascular disorders: Hypotension [reference.medscape.com]
Liver, Gall & Pancreas
- Jaundice
Alcohol consumption: toxic reaction, hepatic damage Patient monitoring • In patient with hepatic dysfunction, monitor hepatic enzyme levels. ☞ Monitor for signs and symptoms of hearing loss, pancreatitis, hepatic dysfunction (jaundice, fatigue, nausea [medical-dictionary.thefreedictionary.com]
Defined Hepatobiliary disorders: Hyperbilirubinemia Cardiac disorders: Cardiac failure, left ventricular failure, tachycardia General disorders and administration site conditions: Face edema, chest pain, chills Hepatobiliary disorders: Hepatic failure, jaundice [reference.medscape.com]
These signs include: unusual fatigue, poor appetite, nausea and/or vomiting, yellowing of the eyes ( jaundice ), dark urine or pale stool. Itraconazole should not be used for treatment of onychomycosis in patients with a history of heart failure. [medicinenet.com]
Skin
- Blister
Ferozsons, Amangarh Nowshera-Pakistan Therapeutic Class Antifungals, Systemic Dosage Form, Composition & NAFDAC Registration Number (NRN) Capsules (NRN: B4-0027): Itraconazole 100 mg Pack Size : available in 1 x 4's blister pack. [rxnigeria.com]
[…] in the mouth, eyes and genitals, or rashes with small pustules or blisters). you experience any hearing loss symptoms. [news-medical.net]
Tell your doctor or get medical help right away if you have any of the following signs or symptoms that may be related to a very bad side effect: Signs of an allergic reaction, like rash; hives; itching; red, swollen, blistered, or peeling skin with or [drugs.com]
Tell your child’s doctor or get medical help right away if your child has any of the following signs or symptoms that may be related to a very bad side effect: Signs of an allergic reaction, like rash; hives; itching; red, swollen, blistered, or peeling [mskcc.org]
- Eczema
Itraconazole is sometimes used for inflammatory skin diseases such as atopic eczema, seborrhoeic dermatitis or psoriasis, if a fungus or yeast is thought to be contributing to the condition. [dermnetnz.org]
[…] and tapeworms); some contraceptive pills (birth control pills), such as dienogest, ulipristal; reboxetine, venlafaxine (used to treat depression and anxiety); cinacalcet, to treat an over active parathyroid; alitretinoin (oral formulation), to treat eczema [news-medical.net]
- Formication
Chromatographic separation is achieved on a BEH C 18 column using gradient elution with mobile phases consisting of 2mM ammonium acetate with 0.1% formic acid in water and methanol. [ncbi.nlm.nih.gov]
Neurologic
- Headache
>10% Systemic fungal infections Nausea (11%) 1-10% (Systemic fungal infections) Rash (9%) Vomiting (5%) Edema (4%) Headache (4%) Abnormal liver function test results (3%) Diarrhea (3%) Fever (3%) Fatigue (3%) Hypertension (3%) Pruritus (3%) Abdominal [reference.medscape.com]
1 Malaise 1 Myalgia 1 Vasculitis 1 Vertigo 1 The following adverse events occurred with an incidence of greater than or equal to 1% (N=112): headache: 10%; rhinitis: 9%; upper respiratory tract infection: 8%; sinusitis, injury: 7%; diarrhea, dyspepsia [rxlist.com]
Nausea / vomiting, diarrhea, headache, stomach upset, or dizziness may occur. If any of these effects last or get worse, tell your doctor or pharmacist promptly. [webmd.com]
Headache Drink plenty of water and ask your pharmacist to recommend a suitable painkiller. [patient.info]
- Tremor
The authors report five cases of tremor related to itraconazole therapy, which occurred within 1-12 months of initiating treatment and resolved gradually following itraconazole withdrawal. [ncbi.nlm.nih.gov]
[…] diarrhea, dyspepsia, flatulence, abdominal pain, dizziness, rash: 4%; cystitis, urinary tract infection, liver function abnormality, myalgia, nausea: 3%; appetite increased, constipation, gastritis, gastroenteritis, pharyngitis, asthenia, fever, pain, tremor [rxlist.com]
[…] disorders: Leukopenia, neutropenia, thrombocytopenia Immune system disorders: Anaphylaxis; anaphylactic, anaphylactoid and allergic reactions; serum sickness; angioneurotic edema Nervous System Disorders: Peripheral neuropathy, paresthesia, hypoesthesia, tremor [reference.medscape.com]
Tremor was noted in 8 patients (4%). There were 21 patients (10%) who experienced sleep disturbance, with frequent waking, daytime somnolence, and associated low mood. Three patients reported dysgeusia. [academic.oup.com]
- Irritability
H315 :Causes skin irritation. H319 :Causes serious eye irritation. Precautionary Statements P264 :Wash hands and face thoroughly after handling. P270 :Do not eat, drink or smoke when using this product. P280 :Wear protective gloves, eye protection. [tcichemicals.com]
[…] overbright appearance of lights painful or difficult urination pale skin pinpoint red spots on the skin puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue rapid weight gain red skin lesions, often with a purple center red, irritated [drugs.com]
If you have kidney or liver problems, do not take SPORANOX capsules with any of the following: colchicine (used to treat gout); fesoterodine or solifenacin (used to control irritated urinary bladder); telithromycin (an antibiotic). [news-medical.net]
Treatment
CONCLUSIONS: For patients with mild or moderate onychomycosis, we recommended a pure medication treatment or combination treatment with medication and laser. [ncbi.nlm.nih.gov]
Prognosis
[…] report highlights the importance of a high degree of clinical suspicion in order to diagnose and treat allergic bronchopulmonary aspergillosis in patients with a long-standing history of severe asthma as early as possible as this has a major impact on prognosis [ncbi.nlm.nih.gov]
Tumor expression and circulating levels of angiogenic factors have been correlated with aggressive tumor growth, predilection for metastasis, and prognosis in a wide array of solid tumors, including lung cancer ( 2–4 ). [doi.org]
Etiology
This is the second report of this fungus as an etiologic agent of eumycetoma in humans. [ncbi.nlm.nih.gov]
Epidemiology
Local epidemiology is vital in guiding prophylaxis strategy. [ncbi.nlm.nih.gov]
Epidemiological aspects of patients with ungual and cutaneous lesions caused by Scytalidium spp. Ann Bras Dermatol. 2010; 85: 805-810. [ Links ] 4. Cob M, Valverde J. Dermatomicosis por Neoscytalidium dimidiatum. Reporte de un caso. [scielo.sa.cr]
European Journal of Epidemiology 9, 455 –6. 5. Powderly, W. G., Robinson, K. & Keath, E. J. ( 1993 ). Molecular epidemiology of recurrent oral candidiasis in human immunodeficiency virus-positive patients: evidence for two patterns of recurrence. [jac.oxfordjournals.org]
Penicillium marneffei infection and recent advances in the epidemiology and molecular biology aspects. Clin Microbiol Rev 2006 ;19: 95 - 110 2. Supparatpinyo K, Khamwan C, Baosoung V, Nelson KE, Sirisanthana T. [nejm.org]
Prevention
All triazole antifungals except itraconazole capsule were effective in preventing IFIs. Posaconazole was more efficacious in reducing IFIs and all-cause deaths than were fluconazole and itraconazole. [ncbi.nlm.nih.gov]
Ketoconazole has been used to prevent relapse, but available information suggests that up to 50 percent of AIDS patients relapse even with ketoconazole treatment. A more effective therapy to prevent recurrence is needed. [clinicaltrials.gov]
(via conazole antifungal agent ) (via triazole antifungal agent ) antifungal drug Any antifungal agent used to prevent or treat fungal infections in humans or animals. [ebi.ac.uk]