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J Clin Pharm Ther ; 37(4): 491-3, 2012 Aug.
Article in English | MEDLINE | ID: mdl-22017245

ABSTRACT

WHAT IS KNOWN AND OBJECTIVE: Anidulafungin is an echinocandin antifungal used to treat invasive fungal infections caused by Candida or Aspergillus species. While the echinocandins are generally well tolerated, novel adverse reactions may occur. Specifically, echinocandins have been associated with histamine-mediated infusion reactions. We describe a novel case of flash pulmonary oedema associated with anidulafungin administration, which may be related to histamine release. CASE SUMMARY: A 52-year-old male developed flash pulmonary oedema after the first dose of anidulafungin, which was characterized by acute onset of spasmodic cough with shortness of breath and chest tightness with subsequent new bilateral perihilar and interstitial oedema visualized on chest X-ray. The patient was treated appropriately with diphenhydramine, hydrocortisone and albuterol with complete recovery and a normal follow-up chest X-ray the following day. WHAT IS NEW AND CONCLUSION: This is the first report of pulmonary oedema attributable to an echinocandin antifungal agent. While such infusion-related adverse events including pulmonary oedema appear uncommon, it is important for clinicians to be aware of this possibility and maintain the drug's infusion rate to <1·1 mg/min and monitor for signs and symptoms of pulmonary oedema.


Subject(s)
Antifungal Agents/adverse effects , Echinocandins/adverse effects , Pulmonary Edema/chemically induced , Albuterol/therapeutic use , Anidulafungin , Antifungal Agents/administration & dosage , Diphenhydramine/therapeutic use , Echinocandins/administration & dosage , Follow-Up Studies , Histamine/metabolism , Humans , Hydrocortisone/therapeutic use , Infusions, Intravenous , Male , Middle Aged , Pulmonary Edema/drug therapy , Pulmonary Edema/physiopathology , Treatment Outcome
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