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This case report aims to describe the unachievable therapeutic VRZ serum levels in a patient with probable invasive pulmonary aspergillosis and idiopathic bilateral chylothorax with chylopericardium requiring intercostal drainage. Moreover, extrahepatic VRZ loss via intercostal drainage was observed by measuring VRZ in the chylous fluid, which was comparable to the serum concentration.<\/jats:p>","DOI":"10.1097\/ftd.0000000000001332","type":"journal-article","created":{"date-parts":[[2025,4,28]],"date-time":"2025-04-28T10:00:17Z","timestamp":1745834417000},"page":"452-456","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":1,"title":["Patient With Probable Invasive Pulmonary Aspergillosis and Idiopathic Bilateral Chylothorax With Chylopericardium May Experience Unachievable Therapeutic Voriconazole Serum Levels"],"prefix":"10.1097","volume":"47","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2830-9248","authenticated-orcid":false,"given":"Vichapat","family":"Tharanon","sequence":"first","affiliation":[{"name":"Clinical Pharmacy Section, Department of Pharmacy, Faculty of Medicine, Ramathibodi Hospital, Mahidol 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