fluconazole IV / Generic mfg. - LARVOL DELTA

Acute Necrotizing Gastritis Secondary to Vancomycin-Resistant Enterococcus faecium : A Non-Surgical Approach (ACG 2026) - "The patient was treated with intravenous (IV) fluconazole, meropenem, vancomycin, and acyclovir...The patient completed a two-week course of IV linezolid with continued clinical improvement and was discharged with outpatient gastroenterology follow-up...Multiple Forrest III ulcers with gastric erosions noted throughout the stomach. Abundant food material was noted."

Diabetes • Gastrointestinal Disorder • Hypotension • Infectious Disease • Metabolic Disorders • Pancreatitis • Peptic Ulcer • Pneumonia • Respiratory Diseases • Septic Shock • Type 2 Diabetes Mellitus

Not Every Distal Esophageal Mass Is Cancer: Acute Necrotizing Esophagitis Masquerading as a Pseudotumor (ACG 2026) - "Management consisted of initial NPO status, IV PPI therapy, IV fluconazole, switching doxycycline to cephalexin, and cautious diet advancement based on clinical recovery. (B) H&E stain, 100Ã, showing pill material and Candida within necroinflammatory debris. (C) PAS stain, 100Ã, highlighting Candida hyphae and yeast forms near pill material."

Esophageal Cancer • Gastrointestinal Disorder • Hematological Malignancies • Infectious Disease • Myelodysplastic Syndrome • Oncology • Septic Shock

A Rare Case of Dysphagia Secondary to Primary Esophageal Brown Bowel Syndrome (ACG 2026) - "Case Description/ A 47-year-old female with systemic lupus erythematosus (SLE) on belimumab and a complex bariatric history (Roux-en-Y gastric bypass, then stomach intestinal pylorus sparing surgery, then conversion to biliopancreatic diversion with duodenal switch [BPD-DS]) presented with three years of progressive dysphagia...She completed two weeks of IV fluconazole with resolution of candidiasis and improvement in dysphagia...Early recognition through fat-soluble vitamin monitoring and biopsy of non-traditional sites in high-risk patients allows vitamin E repletion prior to irreversible myopathy. Figure: (A) Hematoxylin and Eosin (H&E) stain; (B) Periodic acid-Schiff with diastase (PASD) stain; (C) Fontana-Masson stain highlight lipofuscin granules in the esophageal smooth muscle cells."

Clinical • Candidiasis • Gastrointestinal Disorder • Immunology • Inflammatory Arthritis • Lupus • Myositis • Systemic Lupus Erythematosus

Spinal Mucormycosis Following a Traditional Cupping Procedure in a Diabetic Patient: A Rare Case Report from Somalia. (PubMed, Int Med Case Rep J) - "The patient was initially started on empiric intravenous fluconazole, which was discontinued upon confirmation of mucormycosis. Definitive therapy with intravenous liposomal amphotericin B was then initiated, along with broad-spectrum intravenous antibiotics for possible secondary bacterial infection...This case underscores the need for early recognition and a multidisciplinary approach for managing infections involving both medical and surgical interventions. Timely initiation of antifungal therapy is critical for improving patient outcomes and reduce mortality."

Journal • CNS Disorders • Diabetes • Infectious Disease • Metabolic Disorders • Pain • Pneumonia • Pulmonary Disease • Respiratory Diseases • Tuberculosis

Population Pharmacokinetic Modeling of Intravenous Fluconazole to Inform eGFR-Based Dosing: A Simulation Study Demonstrating Superiority over Standard Regimens. (PubMed, Pharmaceutics) - "An eGFR-based dosing nomogram was developed, and simulations demonstrated that this approach outperformed standard dosing regimens in achieving the PK/PD target. These findings suggest an initial loading dose (2.8 times the maintenance dose) followed by individualized, eGFR-guided maintenance dosing to enhance the safety and efficacy of intravenous fluconazole therapy; however, prospective clinical validation is required before routine clinical implementation."

Head-to-Head • Journal • PK/PD data

Clinically Suspected Fungal Laryngitis Masquerading as Laryngeal Carcinoma in a High-Risk Patient. (PubMed, Cureus) - "The patient showed significant clinical improvement following intravenous fluconazole and steroid therapy...Special stains (Periodic acid-Schiff (PAS), Grocott's Methenamine Silver (GMS), and Acid-Fast Bacilli (AFB)) were negative for fungi, though prior antifungal response supported the diagnosis. This case underscores the importance of considering isolated fungal laryngitis in high-risk patients with laryngeal masses to avoid misdiagnosis and unnecessary interventions."

Journal • Cardiovascular • Diabetes • Hepatitis C • Hypertension • Infectious Disease • Laryngeal Cancer • Metabolic Disorders • Mucositis • Oncology • Otorhinolaryngology • Pulmonary Disease • Solid Tumor

SEVERE KERION CELSI IN HEALTHY PEDIATRIC PATIENTS: DIAGNOSTIC AND THERAPEUTIC CHALLENGES (ESPID 2026) - "Initial treatment with griseofulvin failed, and she developed a large purulent scalp mass...Our multidisciplinary team initiated intravenous fluconazole, broad-spectrum antibiotics, and systemic corticosteroids, followed by surgical drainage...However, in our cases, surgical drainage proved decisive once marked inflammation and abscess formation developed. Subsequent clinical monitoring contributed to minimize the risk of permanent scarring alopecia and long-term sequelae."

Clinical • Infectious Disease

CANDIDA PARAPSILOSIS ASSOCIATED WITH STENT PLACEMENT: CASE REPORT AND LITERATURE REVIEW (ESPID 2026) - "Empiric therapy with intravenous liposomal amphotericin-B was started, and subsequent cultures showed susceptibility to azoles, caspofungin, and amphotericin-B; testing with CLSE breakpoints...Antifungal was switched to intravenous fluconazole 12mg/kg/day...Management should consider a prolonged antifungal course, device removal, and suppressive therapy in cases where device is not explanted. Early diagnosis, device removal, and antifungal treatment are crucial for favorable outcomes in Candida related to intravascular devices in infants with repaired congenital heart disease."

Case report • Clinical • Review • Candidiasis • Infectious Disease • Septic Shock

Severe Congenital Candidiasis due to Candida dubliniensis Treated With Fosfluconazole in a Preterm Infant. (PubMed, Case Rep Pediatr) - "The patient was treated with fosfluconazole intravenously...Therefore, fosfluconazole administration was switched to 10 mg/kg/day of micafungin for the next 14 days as the inhibitory concentration of micafungin was lower than that of fluconazole...Some experiments have induced stable fluconazole resistance in vitro in fluconazole-sensitive C. dubliniensis strains after exposure to low concentrations of fluconazole. It may be advisable to consider an alternative antifungal drug when C. dubliniensis is a causative organism."

Journal • Candidiasis • Infectious Disease

Urinary bladder obstruction caused by fungal balls: Unusual computed tomography findings - a case report. (PubMed, Medicine (Baltimore)) - "In high-risk patients (e.g., diabetes), the CT finding of multiple irregular bladder nodules with associated emphysematous cystitis should raise strong suspicion for bladder fungal balls, prompting timely urine culture and appropriate antifungal therapy."

Journal • Cardiovascular • Diabetes • Hypertension • Infectious Disease • Metabolic Disorders • Nephrology • Respiratory Diseases

Unmasking Candida: Angioinvasive Cutaneous Candidiasis Mimicking Septic Vasculitis (AAD 2026) - "After intravenous fluconazole, the patient improved with clear demarcation of necrotic areas. This case highlights the importance of considering angioinvasive fungal infections in critically ill patients with comorbidities presenting with acral purpuric lesions. It also emphasizes the role of biopsy and histopathology in distinguishing septic vasculitis, thrombotic processes, and angioinvasive infection, guiding therapy and improving outcomes."

Candidiasis • Cardiovascular • Dermatopathology • Diabetes • Hypertension • Metabolic Disorders • Septic Shock • Vasculitis

Life-threatening spinal cord injury and occult intercostal artery rupture following low-energy trauma in a patient with ankylosing spondylitis: a case report. (PubMed, BMC Surg) - "This case illustrates the heightened and often unrecognized risk of complex, multisystem injuries in AS patients following seemingly minor trauma. Early recognition of hemothorax without rib fractures should raise high suspicion for intercostal artery injury, necessitating a lowered diagnostic threshold for computed tomography angiography. Transcatheter arterial embolization should be considered the first-line treatment for confirmed intercostal artery bleeding rather than a last resort. Prompt diagnosis, individualized multidisciplinary management, and early referral to specialized centers with interventional and spine surgical capabilities are essential for optimizing outcomes in these high-risk patients."

Journal • Ankylosing Spondylitis • Cardiovascular • CNS Disorders • Hematological Disorders • Immunology • Infectious Disease • Inflammatory Arthritis • Musculoskeletal Diseases • Orthopedics • Osteoporosis • Pneumonia • Respiratory Diseases • Rheumatology • Seronegative Spondyloarthropathies • Thrombosis

Pulmonary mycosis caused by Papiliotrema laurentii following COVID-19 infection: case report. (PubMed, Rev Peru Med Exp Salud Publica) - "During his hospital stay, he received intravenous fluconazole for two weeks, with a favorable outcome...One month after hospital discharge, he presented with cardiorespiratory arrest that did not respond to resuscitation maneuvers. The case highlights the importance of considering saprophytic species among the differential diagnoses of opportunistic mycoses."

Journal • Dermatology • Diabetes • Infectious Disease • Metabolic Disorders • Novel Coronavirus Disease • Type 2 Diabetes Mellitus

A Pharmacokinetic Analysis of Intravenous Fluconazole in Adult Patients Undergoing Mechanical Circulatory Support Device Implantation. (PubMed, Clin Pharmacokinet) - "In patients undergoing MCS device implantation, intravenous fluconazole 200 mg administered pre-operatively and continued daily for 5 days is insufficient for Candida spp. with MICs > 1 mg/L (prophylaxis, AUC0-24/MIC ≥ 50) and > 0.5 mg/L (treatment, AUC0-24/MIC ≥ 100)."

Journal • PK/PD data • Critical care

Candida Spondylodiscitis After Transforaminal Epidural Steroid Injection: A Case Report. (PubMed, Cureus) - "After discontinuation of empirical antibiotics and initiation of intravenous fluconazole, his neurological status improved; beginning the day after surgery, his lower limb motor strength increased from grade 2 to grade 4, and he was discharged to a rehabilitation facility with motor strength of 4. This case underscores the need for early microbiological diagnosis and surgical biopsy in post‑procedural spinal infections unresponsive to empirical antibiotics. Clinicians should consider fungal etiologies, especially in elderly or oncologic patients. To the best of our knowledge, this represents one of the first documented cases of C. albicans spondylodiscitis following TFESI in an immunocompetent patient."

Journal • Back Pain • Infectious Disease • Inflammation • Inflammatory Arthritis • Musculoskeletal Pain • Pain • Seronegative Spondyloarthropathies

Intravenous Liposomal Amphotericin as an Adjunct to Fluconazole in Pediatric Patients with Central Nervous System Coccidioidomycosis: A Single-Center Case Series. (PubMed, J Pediatric Infect Dis Soc) - "Our institutional experience with IV L-AmB in combination with fluconazole for the initial management of pediatric CNS coccidioidomycosis suggests that +IV L-AmB may help reduce disease progression and improve symptom resolution with mild and transient side effects, although the findings of this case series should be interpreted cautiously due to the small cohort size, limited generalizability, and potential confounding factors."

Journal • CNS Disorders • Epilepsy • Infectious Disease • Pain • Pediatrics • Respiratory Diseases

Beyond Immunosuppression: Recurrent Esophageal Candidiasis and Stricture Formation in a Patient With Chronic Alcohol Use (ACG 2025) - "The patient was started on IV Fluconazole, and an HIV test performed was negative...Chronic alcoholism may act as a contributing factor. Early recognition and a combined approach involving antifungal therapy and endoscopic dilatation may be necessary for optimal managementFigure: EGD showing White plaques, ulcerations and stricturesFigure: EGD showing White plaques, ulcerations and strictures"

Clinical • Addiction (Opioid and Alcohol) • Candidiasis • Diabetes • Gastroesophageal Reflux Disease • Gastrointestinal Disorder • Human Immunodeficiency Virus • Infectious Disease • Metabolic Disorders

A Non-Stent Management of Esophageal Perforation Secondary to Candida Esophagitis Near the Gastroesophageal Junction (ACG 2025) - "Pleural fluid analysis was consistent with an exudative effusion, with cultures growing Candida Albicans, leading to initiation of intravenous micafungin therapy...The patient received nasogastric feeds, IV fluconazole, and PPIs...However, stents near the GE junction often migrate distally (7–75%). In select patients without mediastinitis or large perforation, non-operative management with antifungals, proton pump inhibitors, and supportive care may be a viable alternative.Figure: CT chest with oral gastrografin coronal and axial views showing oral contrast leakingfrom the posterior left esophageal lumen into the left hemithorax.Figure: CT chest with oral gastrografin coronal and axial views showing oral contrast leakingfrom the posterior left esophageal lumen into the left hemithorax."

Candidiasis • Gastrointestinal Disorder • Metabolic Disorders • Pulmonary Disease • Respiratory Diseases

Colonic Clue to a Hidden Diagnosis: Isolated GI Histoplasmosis in an Unaware HIV Patient (ACG 2025) - "Empiric vancomycin and piperacillin-tazobactam were started for suspected sepsis. Due to pancytopenia and transaminitis, doxycycline was added for possible tick-borne disease which is endemic to the patient's region, and IV fluconazole was added to cover for candidiasis...Subsequently, the patient was started on antiretroviral therapy (bictegravir, emtricitabine, tenofovir) and Amphotericin B, followed by itraconazole...Abnormal Laboratory Findings on Admission.WBC- White Blood Cell count/ AST- Aspartate Aminotransferase/ ALT - Alanine Aminotransferase/ ALP - Alkaline phosphatase/ HIV- Human Immunodeficiency Virus Figure: Figure 1. Endoscopic and histopathologic findingsA-B: Colonoscopy images showing inflamed, erythematous mucosa with ulceration.C-D: Periodic acid–Schiff (PAS) staining demonstrating intracellular yeast forms within necrotizing granulomas and Grocott's methenamine silver (GMS) stain highlighting numerous fungal organisms consistent with..."

Clinical • Candidiasis • Gastroenterology • Gastrointestinal Disorder • Hematological Disorders • Human Immunodeficiency Virus • Immunology • Infectious Disease • Inflammation • Inflammatory Bowel Disease • Pancreatitis • Septic Shock • CD4

A SILENT INFILTRATION: EOSINOPHILIC PNEUMONIA (CHEST 2025) - "After failing to see improvement with outpatient courses of amoxicillin, doxycycline, and albuterol inhalers, she sought further evaluation...The patient was initially started on ceftriaxone and azithromycin for community acquired pneumonia...During this time, patient was started on IV fluconazole for coccidioidomycosis coverage...With persistently worsening leukocytosis and symptomology, IV methylprednisolone was started...The patient was discharged on oral prednisone and supplemental oxygen with pulmonology follow-up... Eosinophilic pneumonia is a rare but significant cause of respiratory symptoms, especially in cases where standard pneumonia treatments fail. This case emphasizes the importance of considering EP in patients with persistent respiratory symptoms and peripheral eosinophilia. Early diagnosis and prompt treatment with corticosteroids can lead to rapid improvement and prevent severe outcomes."

Cough • Eosinophilia • Human Immunodeficiency Virus • Immunology • Infectious Disease • Inflammation • Influenza • Interstitial Lung Disease • Novel Coronavirus Disease • Pneumonia • Respiratory Syncytial Virus Infections

A CURIOUS CASE OF A WEDGE-SHAPED NECROTIC MASS: UNRAVELING PULMONARY COCCIDIOIDOMYCOSIS (CHEST 2025) - "Serologic testing confirmed Coccidioides infection and IV fluconazole was initiated.The patient subsequently developed acute respiratory distress syndrome (ARDS) with progressive hypoxia, requiring intubation and mechanical ventilation... Pulmonary coccidioidomycosis can present with necrotic lung masses, raising concern for malignancy, particularly in immunocompromised individuals. Early recognition and differentiation from neoplastic processes are critical prompt antifungal therapy initiation and optimal patient management. This case underscores the need for heightened clinical suspicion and comprehensive diagnostic workup in endemic regions."

Clinical • Acute Respiratory Distress Syndrome • Cardiovascular • CNS Disorders • Cough • Diabetes • Hypertension • Infectious Disease • Metabolic Disorders • Pneumonia • Respiratory Diseases • Septic Shock • Thrombosis

Fluconazole exposure during mechanical circulatory support (MCS) device insertion. (PubMed, Int J Antimicrob Agents) - "In ten patients undergoing MCS device insertion, fluconazole 200 to 400 mg IV achieved median plasma levels of between 3 to 4 mg/L throughout the surgical procedure and may not adequately cover for C. glabrata."

Journal • Candidiasis • Cardiovascular • Congestive Heart Failure • Heart Failure • Infectious Disease

Severe disseminated cryptococcosis, with asymptomatic central nervous system involvement, in a very late presenter (EACS 2025) - "Due to a lack of Amphotericin B and 5-Flucytosine, he initially received high-dose intravenous Fluconazole (1600 mg/day) for 30 days, which was replaced by Voriconazole because of continued blood culture positivity; they turned negative after five weeks. A single dose of liposomal Amphotericin B (10 mg/kg) was administered at week 7th.ART (DOR-TDF-3TC) was also initiated at this moment... Our case highlights the diagnostic and therapeutic challenges of a severe disseminated cryptococcosis, particularly in the absence of neurological symptoms despite extensive CNS involvement, with the importance of maintaining a high index of suspicion for cryptococcal meningitis in all patients with a CD4 count of less than 100 cells/mm³, regardless of their clinical presentation. Additionally, the importance of carefully timing ART initiation to avoid IRIS. Figure:"

Human Immunodeficiency Virus • Infectious Disease • CD4

Regulatory gaps in over-the-counter antifungal access for vulvovaginal candidiasis in Uganda: A policy analysis framework. (PubMed, IJID Reg) - "Five critical policy gaps were identified: (i) diagnostic accuracy: no provisions ensure proper differentiation of VVC from other conditions; (ii) treatment completion: no mechanisms ensure adherence to recommended treatment durations; (iii) safety screening: absence of pregnancy screening requirements for contraindicated fluconazole; (iv) personnel training, inadequate VVC-specific training for drug shop operators; and (v) product regulation: insufficient oversight of combination products...The identified policy gaps potentially compromise women's health outcomes through inappropriate treatment, incomplete therapy courses, preventable medication risks, and conditions that favor the development of antifungal resistance. The policy tensions between accessibility and appropriate use highlight the need for gender-sensitive pharmaceutical regulations that maintain access while implementing targeted safeguards for improved health outcomes and antimicrobial stewardship."

Journal • Candidiasis • Vaginitis • Women's Health

Candida graft arteritis after kidney transplantation: two cases and literature review. (PubMed, Oxf Med Case Reports) - "This report highlights the importance of early recognition, maintenance of sterile conditions during organ transport and vigilant postoperative monitoring to minimise the occurrence of this life-threatening complication burden."

Journal • Cardiovascular • Transplantation