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Multifocal periostitis as a complication of chronic use of voriconazole in a lung transplant recipient

R Tedja1, A El-Sherief, T Olbrych

  • 1Department of Infectious Disease, Cleveland Clinic Foundation, Cleveland, Ohio 44195, USA. tedjar@ccf.org

Transplant Infectious Disease : an Official Journal of the Transplantation Society
|May 14, 2013
PubMed

Insights

Chronic voriconazole use in lung transplant recipients can lead to periostitis, a bone complication. Early recognition and stopping the antifungal drug can resolve symptoms.

Area of Science:

  • Transplantation medicine
  • Mycology
  • Pharmacology

Background:

  • Fungal infections are a significant concern in solid organ transplant recipients.
  • Prolonged antifungal therapy is often required for invasive fungal infections.

Observation:

  • A lung transplant recipient developed periostitis after 9 months of oral voriconazole treatment for probable pulmonary aspergillosis.

Findings:

  • The patient exhibited multifocal periostitis affecting both the axial and appendicular skeleton.
  • Periostitis is identified as a complication of chronic voriconazole use.

Implications:

  • Early diagnosis of voriconazole-induced periostitis can prevent unnecessary investigations and procedures.
  • Discontinuation of voriconazole is recommended for symptom improvement in such cases.
Keywords:
hypertrophic osteoarthropathyperiostitissolid organ transplantsvoriconazole

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