Long QT Syndrome and Torsade de Pointes in a Patient Receiving Fluconazole

Letters16 November 1999Long QT Syndrome and Torsade de Pointes in a Patient Receiving FluconazoleSven Wassmann, MD, Georg Nickenig, MD, and Michael Böhm, MDSven Wassmann, MDUniversity of Cologne; 50924 Cologne, Germany (Wassmann)University of Cologne; 50924 Cologne, Germany (Nickenig)University of Cologne; 50924 Cologne, Germany (Böhm), Georg Nickenig, MDUniversity of Cologne; 50924 Cologne, Germany (Wassmann)University of Cologne; 50924 Cologne, Germany (Nickenig)University of Cologne; 50924 Cologne, Germany (Böhm), and Michael Böhm, MDUniversity of Cologne; 50924 Cologne, Germany (Wassmann)University of Cologne; 50924 Cologne, Germany (Nickenig)University of Cologne; 50924 Cologne, Germany (Böhm)Author, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-131-10-199911160-00034 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:A 59-year-old woman with liver cirrhosis and peritonitis was admitted to our hospital. Candida albicans was detected in ascitic fluid, and intravenous therapy with fluconazole (400 to 800 mg/d for 5 weeks) was given, followed by intraperitoneal administration (150 mg/d). One day after the second intraperitoneal administration, palpitations, polymorphic ventricular premature complexes (VPC), and syncope occurred. Results of cardiovascular examination were normal. In contrast to a normal electrocardiogram at admission, electrocardiography now showed polymorphic VPC, T-wave inversions, alternating T-wave amplitudes, and a prolonged time-corrected QT interval (QTc) of 606 ms. Findings on echocardiography and chest radiography were ...References1. Pittrow L, Penk A. Plasma and tissue concentrations of fluconazole: discussion of the breakpoint problem. Mycoses. 1996;39 Suppl 2 58-65. CrossrefMedlineGoogle Scholar2. Roden DM. A practical approach to torsade de pointes. Clin Cardiol. 1997;20:285-90. CrossrefMedlineGoogle Scholar3. Albengres E, Le Louet H, Tillement JP. Systemic antifungal agents. Drug interactions of clinical significance. Drug Saf. 1998;18:83-97. CrossrefMedlineGoogle Scholar4. Keller E, Reetze P, Schollmeyer P. Drug therapy in patients undergoing continuous ambulatory peritoneal dialysis. Clinical pharmacokinetic considerations. Clin Pharmacokinet. 1990;18:104-17. CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: University of Cologne; 50924 Cologne, Germany (Wassmann)University of Cologne; 50924 Cologne, Germany (Nickenig)University of Cologne; 50924 Cologne, Germany (Böhm) PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited ByAntimicrobial agents and torsades de pointesFluconazole-associated QT interval prolongation and Torsades de Pointes in a paediatric patientIsavuconazole shortens the QTc intervalQTc prolongation during ciprofloxacin and fluconazole combination therapy: prevalence and associated risk factorsFluconazole-induced long QT syndrome via impaired human ether-a-go-go-related gene (hERG) protein trafficking in rabbitsFluconazoleCardiotoxicity Induced by Antifungal DrugsQT Prolongation with Quinolone Antimicrobial AgentsEffect of Combined Fluoroquinolone and Azole Use on QT Prolongation in Hematology PatientsAntifungal Miconazole Induces Cardiotoxicity Via Inhibition of APE/Ref-1-Related Pathway in Rat Neonatal CardiomyocytesFluconazole inhibits hERG K+ channel by direct block and disruption of protein traffickingDrug-Induced QT-Interval Prolongation: Considerations for CliniciansCellular Mechanisms, Molecular Targets, and Structure-Function Relationships in Drug-Induced Arrhythmias: Antihistamines, Psychoactive Drugs, and Antimicrobial AgentsANTIFUNGAL DRUGSPharmacology of Azole Antifungal AgentsEffect of high-dose fluconazole on QT interval in patients with human immunodeficiency virus (HIV)-associated cryptococcal meningitisADVERSE CARDIOVASCULAR EFFECTS OF NON-CARDIOVASCULAR DRUGSProarrhythmic Potential of Antimicrobial AgentsCurrent Options in Antifungal PharmacotherapyTorsades de Pointes Ventricular Tachycardia in a Pediatric Patient Treated with FluconazoleIsolated Pulmonary Cryptococcosis in an Immunocompetent Patient Presenting with Right Shoulder Pain: A Case Report and Review of the LiteratureTorsades de pointes associated with voriconazole useTorsade de pointes induced by systemic antifungal agents: lessons from a retrospective analysis of published case reportsLong QTc Interval and Torsade de Pointes Caused by FluconazoleTorsades de pointes upon fluconazole administration in a patient with acute myeloblastic leukemiaEffects of the antifungal antibiotic clotrimazole on human cardiac repolarization potassium currentsFluconazoleArrhythmogenic Effects of Arsenic Trioxide in Patients With Acute Promyelocytic Leukemia and an Electrophysiological Study in Isolated Guinea Pig Papillary MusclesFrequency of potential azole drug-drug interactions and consequences of potential fluconazole drug interactionsArsenic Trioxide Therapy in Relapsed or Refractory Japanese Patients with Acute Promyelocytic Leukemia: Updated Outcomes of the Phase II Study and Postremission TherapiesCurrent use of anti-infectives in dermatologyQT Interval Prolongation and Torsades de Pointes Due to a Coadministration of Metronidazole and AmiodaroneBlockade of HERG cardiac K + current by antifungal drug miconazoleToxic Interactions between Fluconazole and Disopyramide in Chick EmbryosQT Prolongation with Antimicrobial AgentsPulmonary Cryptococcosis in Nonimmunocompromised PatientsTorsade de Pointes Due to Noncardiac DrugsStructural and Functional Basis for the Long QT Syndrome: Relevance to Veterinary PatientsClinical Relevance and Management of Drug-Related QT Interval ProlongationKamertachycardie bij uitleiding uit anesthesie door medicamenteus geïnduceerd verlengd qt-intervalProbable Case of Torsades de Pointes Induced by FluconazoleEarly Treatment with Fluconazole in Adult ICU Patients at High Risk for Severe CandidiasisSafety of Non-Antiarrhythmic Drugs that Prolong the QT Interval or Induce Torsade de PointesDrugs and Cardiotoxicity in HIV and AIDSFluconazole-Induced Torsade de PointesRisk Assessment for Antimicrobial Agent-Induced QTc Interval Prolongation and Torsades de PointesAntifungal drugsFluconazole 16 November 1999Volume 131, Issue 10Page: 797KeywordsArrhythmiaBlood plasmaDrugsElectrocardiographyPotassiumSyncopeTachycardiaThoraxThyroid hormonesTroponin T Issue Published: 16 November 1999 CopyrightCopyright © 1999 by American College of Physicians. 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