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Published on: September 16, 2020
[Voriconazole-induced periostitis]
Ditte Marie Jakobsen1, Bjarte Aspenes Justad, Jannik Helweg-Larsen
1dittemarie@gmail.com.
Abstract:
In this case report, a 49-year-old man was diagnosed with influenza-associated invasive aspergillosis. Voriconazole therapy was initiated and adjusted to meet therapeutic range. After 16 weeks of treatment the patient was admitted with multifocal, skeletal pains. Alkaline phosphatase was 1,900 U/L and S-voriconazole 9.9 mg/l. A bone scintigraphy and SPECT-CT were performed, and the diagnostic images along with the clinical findings were consistent with voriconazole-induced periostitis. Voriconazole therapy was discontinued, and isavuconazole therapy was initiated, and the patient's symptoms resolved completely.
Insights
This case report details a patient with influenza-associated invasive aspergillosis who developed voriconazole-induced periostitis. Switching to isavuconazole resolved the patient's symptoms.
Area of Science:
- Medical Mycology
- Pharmacology
- Radiology
Background:
- Influenza-associated invasive aspergillosis is a severe complication.
- Voriconazole is a key antifungal agent, but can have adverse effects.
- Periostitis is a rare but debilitating side effect of voriconazole therapy.
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