Abstract
A patient with hepatitis C infection and cavitary pul- monary coccidioidomycosis is reported. Treatment of hepatitis C was associated with resolution of flucona- zole-induced hepatotoxicity. Successful treatment of he- patitis C enabled the patient to tolerate increaseing doses of fluconazole. This case highlights that hepatic toxicity of fluconazole can improve after successful treatment of hepatitis C.
Highlights
Coccidioidomycosis is fungal infection endemic to the southwestern United States, particular Arizona
Oral azole antifungal agents such as fluconazole are the standard therapy for treatment of coccidioidomycosis
Azoles are metabolized by the cytochrome P-450 enzyme (CYP) system and abnormal liver function tests (LFT) have been described with azoles [3,4]
Summary
Coccidioidomycosis is fungal infection endemic to the southwestern United States, particular Arizona. It commonly presents as a community-acquired pneumonia. Oral azole antifungal agents such as fluconazole are the standard therapy for treatment of coccidioidomycosis [1,2]. Azole-induced LFT abnormality is usually asymptomatic and reversible after the offending medication is discontinued [5,6,7,8,9,10]. In we report a case of a patient with hepatitis C virus (HCV) infection with multiple attempts to treat pulmonary coccidiodymycosis with fluconazole which antifungal treatment could not be sustained because of LFT abnormality
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