Posaconazole-induced podocyte phospholipidosis

Podocyte lysosomal vacuolization can be seen in proteinuric diseases, in lysosomal storage diseases, such as Fabry disease, and in association with drugs, such as hydroxychloroquine. A 20-year-old woman underwent heart transplant in 2001 for left hypoplastic heart syndrome. She developed end-stage kidney disease secondary to calcineurin inhibitor toxicity and received a living related donor kidney transplant in 2010. In 2019, she developed fungal pneumonia, and bronchoalveolar lavage cultures grew Penicillium and Fusarium, which was initially treated with voriconazole followed by lifelong prophylaxis with posaconazole.