Hospital Pharmacy Services, Mayo Clinic, Rochester, MN 55905, USA.
J Clin Pharm Ther. 2012 Aug;37(4):491-3. doi: 10.1111/j.1365-2710.2011.01309.x. Epub 2011 Oct 20.
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.
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.
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.
安尼达fungin 是一种棘白菌素类抗真菌药物，用于治疗由念珠菌或曲霉菌引起的侵袭性真菌感染。虽然棘白菌素类药物通常耐受性良好，但可能会出现新的不良反应。具体来说，棘白菌素类药物与组胺介导的输注反应有关。我们描述了一例与安尼达fungin 给药相关的新型闪光肺水肿病例，这可能与组胺释放有关。
一名 52 岁男性在接受安尼达fungin 首剂治疗后出现闪光性肺水肿，其特征为急性发作性痉挛性咳嗽，伴有呼吸困难和胸闷，随后胸部 X 线显示双侧肺门周围和间质性水肿。患者接受了苯海拉明、氢化可的松和沙丁胺醇的适当治疗，第二天完全康复，胸部 X 线检查正常。
这是首例与棘白菌素类抗真菌药物相关的肺水肿病例报告。虽然此类与输注相关的不良反应，包括肺水肿，似乎并不常见，但临床医生了解这种可能性并将药物的输注速度保持在<1.1mg/min 以下并监测肺水肿的体征和症状非常重要。
