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Published on: July 18, 2014

A case of periostitis secondary to voriconazole therapy in a heart transplant recipient

Steven M Wise1, Michael A Wilson

  • 1Department of Radiology, University of Wisconsin Hospital and Clinics, Madison, WI, USA. swise@uwhealth.org

Clinical Nuclear Medicine
|February 3, 2011
PubMed

Insights

Long-term voriconazole use can cause drug-induced periostitis, a bone condition, in heart transplant recipients. Discontinuing voriconazole relieved the patient's bone pain and myalgias.

Area of Science:

  • Medical research
  • Pharmacology
  • Transplantation medicine

Background:

  • Voriconazole is a crucial antifungal medication used for Aspergillus infections.
  • Long-term voriconazole therapy is associated with potential adverse effects.
  • Drug-induced periostitis is a rare but serious side effect.

Observation:

  • A 66-year-old heart transplant recipient developed progressive bone pain and myalgias.
  • The patient had been on voriconazole for nine months to treat a pulmonary Aspergillus infection.
  • Laboratory tests revealed an elevated alkaline phosphatase level.

Findings:

  • This case highlights drug-induced periostitis in a heart transplant patient on long-term voriconazole.
  • The condition mimics rheumatologic diseases but is linked to voriconazole exposure.
  • Symptoms resolved after voriconazole discontinuation, confirming the drug's role.

Implications:

  • Clinicians should consider voriconazole-induced periostitis in transplant patients with bone pain.
  • Early recognition and drug cessation can prevent prolonged morbidity.
  • This finding expands the understanding of voriconazole's side effect profile in immunocompromised patients.

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