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Related Concept Videos

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.
82
Kidney Transplant III: Nursing Management01:16

Kidney Transplant III: Nursing Management

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Postoperative Nursing Management for Kidney Transplant PatientsPostoperative nursing management care includes monitoring the surgical site, encouraging early movement, and promoting lung health through breathing exercises. Nurses also administer prescribed medications like H2-blockers, such as famotidine, or proton pump inhibitors, like omeprazole, to help prevent gastrointestinal ulcers and bleeding. Fungal infections in the mouth and bladder can result from immunosuppressive and antibiotic...
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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...
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Endocarditis IV: Nursing Management01:29

Endocarditis IV: Nursing Management

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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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Kidney Transplant I: Introduction01:28

Kidney Transplant I: Introduction

67
A kidney transplant is a surgical approach that involves replacing a non-functioning kidney with a healthy one from a donor. This procedure is often a treatment option for end-stage renal disease (ESRD) patients. The method requires careful recipient selection, including evaluating various medical and psychosocial factors. These criteria vary between transplant centers but generally include assessments of the patient's overall health, adherence to medical recommendations, and lifestyle...
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Pericarditis III: Medical Management01:17

Pericarditis III: Medical Management

43
The primary objectives of managing pericarditis are to determine the underlying cause, provide effective therapy for treatment and symptom relief, and promptly detect signs and symptoms of cardiac tamponade. The following outlines the essential aspects of medical management for pericarditis:ObjectivesDetermine the Cause: Identifying the underlying cause of pericarditis is crucial for targeted treatment. Causes include viral infections, autoimmune diseases, post-cardiac injury syndrome, and...
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Surgical Angiogenesis in Porcine Tibial Allotransplantation: A New Large Animal Bone Vascularized Composite Allotransplantation Model
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Voriconazole-induced periostitis post lung transplantation.

Orla M Murray1,2, John P Hynes1, Michelle A Murray3

  • 1Department of Radiology, Mater Misericordiae University Hospital, Eccles Street, Dublin 7, Ireland.

Radiology Case Reports
|March 21, 2022
PubMed
Summary

Chronic voriconazole use can lead to diffuse periostitis, a rare complication in transplant recipients. This condition presents with bone pain and characteristic imaging findings, requiring careful monitoring.

Keywords:
Lung transplantationPeriostitisVoriconazole

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Area of Science:

  • Pharmacology
  • Rheumatology
  • Infectious Diseases

Background:

  • Voriconazole is a broad-spectrum triazole antifungal crucial for treating invasive fungal infections, particularly in immunocompromised patients like transplant recipients.
  • Diffuse periostitis is an exceptionally rare adverse effect associated with prolonged voriconazole therapy.
  • This condition is characterized by diffuse bone pain, elevated serum alkaline phosphatase, and increased fluorine levels.

Observation:

  • A 71-year-old female lung transplant recipient developed multifocal bone pain.
  • The patient had a history of severe sepsis from Scedosporium apiospermum requiring lifelong voriconazole prophylaxis.
  • Clinical presentation included diffuse bone pain, elevated alkaline phosphatase, and hyperfluoridosis.

Findings:

  • The patient exhibited diffuse periostitis, a very rare complication of long-term voriconazole therapy.
  • Radiographic imaging revealed characteristic periosteal thickening with a dense, nodular, irregular, and bilateral pattern.
  • Laboratory findings showed elevated serum alkaline phosphatase and fluorine levels.

Implications:

  • This case underscores the importance of recognizing diffuse periostitis as a potential complication of chronic voriconazole therapy.
  • Early diagnosis through characteristic clinical and imaging findings is crucial for managing this rare adverse effect.
  • Understanding this complication may inform long-term monitoring strategies for patients on prolonged voriconazole prophylaxis.