Pulmonary aspergillosis due to methimazole-induced neutropenia: a case report

Authors

  • Miguel E. Pinto Servicio de Endocrinología, Hospital Nacional Cayetano Heredia. Lima, Perú. Facultad de Medicina Alberto Hurtado, Universidad Peruana Cayetano Heredia. Lima, Perú. Médico endocrinólogo.
  • Claudia Banda Facultad de Medicina Alberto Hurtado, Universidad Peruana Cayetano Heredia. Lima, Perú. Instituto de Medicina Tropical Alexander von Humboldt, Universidad Peruana Cayetano Heredia. Lima, Perú. médico cirujano.
  • Carlos Seas Facultad de Medicina Alberto Hurtado, Universidad Peruana Cayetano Heredia. Lima, Perú. Instituto de Medicina Tropical Alexander von Humboldt, Universidad Peruana Cayetano Heredia. Lima, Perú. médico infectólogo.

DOI:

https://doi.org/10.17843/rpmesp.2012.292.351

Keywords:

Aspergillus, Pulmonary aspergillosis, Neutropenia, Methimazole, Antithyroid agents

Abstract

A 48-year old woman with a recent diagnosis of Graves’ disease arrived at the emergency room with fever, palpitations, and a sore throat. Her regular treatment included methimazole. On admission, laboratory results showed suppressed TSH, elevated free thyroxine, and neutropenia. She was admitted and started on antibiotics and granulocyte-macrophage colony stimulating factor (gm-csf). After ten days, the patient developed leukocytosis, fever, and hemoptysis. Chest CT scan showed a lung cavity with multiple nodules in the upper right lobe. Cultures from a lung biopsy were positive for Aspergillus Fumigatus and Aspergillus Flavus. Amphotericin B was started but then switched to voriconazole, with both treatments failing to result in clinical improvement. The patient died of multi-organ failure.

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Published

2014-01-31

Issue

Section

Case Report

How to Cite

1.
Pinto ME, Banda C, Seas C. Pulmonary aspergillosis due to methimazole-induced neutropenia: a case report. Rev Peru Med Exp Salud Publica [Internet]. 2014 Jan. 31 [cited 2024 Oct. 12];29(2). Available from: https://rpmesp.ins.gob.pe/index.php/rpmesp/article/view/351