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

  1. Rinki Singh, MBCHB1 and
  2. Tim Cundy, MD12
  1. 1Auckland Diabetes Centre, Auckland, New Zealand
  2. 2Department of Medicine, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
  1. Address correspondence to Tim Cundy, MD, Department of Medicine, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand. E-mail: t.cundy{at}auckland.ac.nz

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 …

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