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Related Concept Videos

Pericarditis I: Introduction01:22

Pericarditis I: Introduction

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Pericarditis is defined as the inflammation of the pericardium, the thin, sac-like membrane surrounding the heart. This condition can cause significant chest pain and other symptoms, often necessitating medical intervention. The pericardium has two layers: the inner visceral layer and the outer parietal layer, separated by a small amount of fluid that reduces friction during heartbeats.Types of PericarditisPericarditis can be classified into several types based on the duration and nature of the...
86
Endocarditis IV: Nursing Management01:29

Endocarditis IV: Nursing Management

121
Infective endocarditis (IE) is a chronic infection of the heart's endocardium, primarily affecting the heart valves. A detailed nursing assessment for a patient with IE involves collecting subjective and objective data to ensure an accurate diagnosis and timely intervention.Subjective DataThe nurse gathers information about the patient's symptoms and complaints during the subjective assessment. Patients with infective endocarditis often report non-specific symptoms that can mimic other...
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Pericarditis IV: Nursing Management01:25

Pericarditis IV: Nursing Management

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Pericarditis, an inflammation of the pericardium, necessitates diligent nursing management to ensure effective patient care and recovery. The initial step in managing pericarditis is a comprehensive patient medical assessment.The patient reports chest pain aggravated by breathing, coughing, and swallowing, which worsens when lying supine. The pain often improves when sitting up and leaning forward. Additional symptoms may include fever, malaise, and, in severe cases, signs of heart failure.
132
Endocarditis II: Clinical Features of Infective Endocarditis01:25

Endocarditis II: Clinical Features of Infective Endocarditis

93
Endocarditis can present various clinical features depending on the causative organism and the patient's underlying health conditions. Initially, the clinical features of infective endocarditis develop gradually, presenting with nonspecific symptoms that can be easily mistaken for other illnesses.General SymptomsEarly symptoms of infective endocarditis are fever, chills, weakness, malaise, fatigue, and weight loss. These symptoms reflect the systemic nature of the infection and the body's...
93
Endocarditis I: Introduction01:25

Endocarditis I: Introduction

129
Introduction:Endocarditis is the infection of the endocardium, the inner lining of the heart and its valves. When the heart muscle is involved, the condition is termed myocarditis, while an infection of the outer lining is called pericarditis. Infective endocarditis (IE) primarily affects the endocardium, where pathogens adhere to the valves or lining, forming vegetation that can lead to severe complications. Infective endocarditis occurs when microorganisms, usually bacteria from other body...
129
Endocarditis III: Medical Management01:18

Endocarditis III: Medical Management

74
Infective endocarditis management involves a multifaceted approach encompassing infection prevention, lifestyle modifications, pharmacological therapy, and surgical management.Infection Prevention:Hand Hygiene: Thorough handwashing is crucial to prevent the spread of infection. Hand hygiene should be performed regularly, especially before and after using the restroom.Oral Hygiene: Good oral hygiene is essential. It includes brushing teeth immediately after waking up and before bed, flossing...
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Voriconazole-induced periostitis.

D C Fernández Ávila1, M Diehl2, A M Degrave2

  • 1Rheumatology Section, Internal Medicine Department, Hospital Italiano de Buenos Aires, Buenos Aires. diana.fernandez@hospitalitaliano.org.ar.

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Summary
This summary is machine-generated.

Chronic voriconazole use can cause periostitis, a painful bone condition, in immunosuppressed patients. Discontinuing the drug typically resolves these adverse effects, as seen in a leukemia patient case.

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Area of Science:

  • Pharmacology
  • Radiology
  • Oncology

Background:

  • Voriconazole, a triazole antifungal, is crucial for treating fungal infections in immunocompromised individuals.
  • Chronic voriconazole therapy can lead to adverse effects, including periostitis, skeletal pain, and elevated alkaline phosphatase and serum fluoride levels.
  • Periostitis diagnosis relies on radiography, and symptoms often resolve upon drug cessation.

Observation:

  • A 44-year-old female with acute myeloid leukemia developed invasive fungal infection post-stem cell transplant.
  • She received voriconazole treatment and subsequently presented with symptoms and radiographic signs of periostitis.
  • Clinical manifestations included severe skeletal pain and elevated alkaline phosphatase and serum fluoride levels.

Findings:

  • Radiographic imaging confirmed a multifocal, asymmetric, diffuse, and nodular periosteal reaction.
  • Discontinuation of voriconazole therapy resulted in the complete resolution of clinical symptoms and radiographic findings.
  • This case highlights the diagnostic utility of radiography in identifying drug-induced periostitis.

Implications:

  • This case underscores the importance of recognizing voriconazole-induced periostitis as a potential adverse effect.
  • Prompt diagnosis and drug withdrawal can lead to favorable patient outcomes and symptom resolution.
  • Clinicians should consider voriconazole toxicity in immunocompromised patients presenting with unexplained skeletal pain and periosteal reactions.