Torsades de Pointes Ventricular Tachycardia in a Pediatric Patient Treated with Fluconazole

• Published in: Pediatric cardiology Vol. 29; no. 1; pp. 210 - 213
• Main Authors: Esch, Jesse J., Kantoch, Michal J.
• Format: Journal Article
• Language: English
• Published: New York Springer-Verlag 2008
• Subjects: Antifungal Agents - adverse effects; Antifungal Agents - pharmacology; Antifungal Agents - therapeutic use; Candidiasis - drug therapy; Cardiac Surgery; Cardiology; Case Report; Child; Electrocardiography; Fluconazole - adverse effects; Fluconazole - pharmacology; Fluconazole - therapeutic use; Heart Conduction System - drug effects; Humans; Male; Medicine; Medicine & Public Health; Shock, Septic - drug therapy; Shock, Septic - microbiology; Torsades de Pointes - chemically induced; Vascular Surgery; QT interval; Fluconazole; Long QT Syndrome; Torsades de Pointes
• ISSN: 0172-0643; 1432-1971
• DOI: 10.1007/s00246-007-9076-0

Fluconazole is an antifungal medication that has been reported to cause prolongation of the QT interval and Torsades de Pointes (TdP) ventricular tachycardia in adults. We describe the case of an 11-year-old child treated with Fluconazole who developed ventricular arrhythmia culminating in TdP. We discuss the possible roles played by genetic and environmental factors in this child’s rhythm disturbances. After briefly summarizing similar cases from the adult literature, we outline the putative mechanism by which Fluconazole may cause arrhythmia. This case should alert pediatricians to the possible risks of Fluconazole use, especially in the presence of electrolyte abnormalities, diuretic use, therapy with other pro-arrhythmic agents, or suspicion of congenital Long-QT Syndrome.