Voriconazole-associated visual disturbances and hallucinations

Area of Science:

• Medical Mycology
• Clinical Pharmacology
• Neuro-Ophthalmology

Background:

• Voriconazole is a crucial second-generation azole antifungal.
• It is widely used for preventing and treating fungal infections, especially in leukemia patients.
• Voriconazole is the primary treatment for invasive aspergillosis.

Observation:

• A 16-year-old girl developed acute visual disturbances and hallucinations (visual and auditory).
• These symptoms emerged shortly after initiating intravenous voriconazole therapy.
• No other etiological cause was identified for the neurological symptoms.

Findings:

• The observed symptoms were attributed to voriconazole as a potential side effect.
• The simultaneous occurrence of visual disturbances and hallucinations is a rare adverse event.
• This case underscores the neurotoxic potential of voriconazole.

Implications:

• Clinicians should be vigilant for neurological side effects, including visual disturbances and hallucinations, during voriconazole treatment.
• Prompt recognition and management of these adverse events are crucial for patient safety.
• Further research into the neurotoxicity mechanisms of azole antifungals may be warranted.