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  • Title: [Pulmonary aspergillosis due to methimazole-induced neutropenia: a case report].
    Author: Pinto ME, Banda C, Seas C.
    Journal: Rev Peru Med Exp Salud Publica; 2012 Jun; 29(2):255-8. PubMed ID: 22858775.
    Abstract:
    A 48-year old woman with a recent diagnosis of Graves' disease arrived at the emergency room with fever, palpitations, and a sore throat. Her regular treatment included methimazole. On admission, laboratory results showed suppressed TSH, elevated free thyroxine, and neutropenia. She was admitted and started on antibiotics and granulocyte-macrophage colony stimulating factor (gm-csf). After ten days, the patient developed leukocytosis, fever, and hemoptysis. Chest CT scan showed a lung cavity with multiple nodules in the upper right lobe. Cultures from a lung biopsy were positive for Aspergillus Fumigatus and Aspergillus Flavus. Amphotericin B was started but then switched to voriconazole, with both treatments failing to result in clinical improvement. The patient died of multi-organ failure.
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