Itraconazole-Induced Painful Neuropathy in a Man With Type 1 Diabetes

The antifungal agent itraconazole is considered safe in patients with diabetes (1,2) but has been associated with acute painful neuropathy in patients taking vincristine (3–5). We describe a patient with diabetic neuropathy who developed acute painful neuropathy with itraconazole therapy. A 37-year-old man with poorly controlled type 1 diabetes of 19 years’ duration presented with an excematous rash affecting his lower abdomen. Skin scrapings grew C. albicans . Itraconazole (200 mg/day) was prescribed, but on the 4th day of treatment he developed acute bilateral leg weakness with stabbing pain in the hips and legs and difficulty walking. He …