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Related Concept Videos

Pericarditis I: Introduction01:22

Pericarditis I: Introduction

18
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 II: Clinical Features of Infective Endocarditis01:25

Endocarditis II: Clinical Features of Infective Endocarditis

22
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...
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Endocarditis I: Introduction01:25

Endocarditis I: Introduction

21
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...
21
Pericarditis IV: Nursing Management01:25

Pericarditis IV: Nursing Management

34
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.
34
Endocarditis IV: Nursing Management01:29

Endocarditis IV: Nursing Management

22
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...
22
Myocarditis I: Introduction01:21

Myocarditis I: Introduction

23
Myocarditis is inflammation of the myocardium, which is the muscular layer of the heart.EtiologyMyocarditis has a diverse etiology, including a wide range of infectious and non-infectious causes:Infectious CausesViral: Common viruses include Coxsackie A and B, adenovirus, parvovirus B19, enteroviruses, and influenza A.Bacterial: Examples include infections caused by Streptococcus, Staphylococcus, and Mycoplasma species.Rickettsial: Infections like Rocky Mountain spotted fever can result in...
23

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Author Spotlight: Advancing Research on Candida albicans Biofilm-Associated Prosthetic Joint Infections
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Voriconazole-Induced Diffuse Periostitis.

Simona Stefan1, Nadera Altork2, Yazan Alzedaneen2

  • 1Division of Endocrinology & Diabetes, Albert Einstein College of Medicine, Montefiore Medical Center, Bronx, New York.

AACE Clinical Case Reports
|October 3, 2022
PubMed
Summary
This summary is machine-generated.

Low-dose voriconazole can cause diffuse periostitis, a bone condition, in transplant patients. Discontinuing the antifungal medication typically resolves symptoms, highlighting the importance of early diagnosis.

Keywords:
ALP, alkaline phosphatasealkaline phosphatasefluorosisperiostitisvoriconazole

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Area of Science:

  • Medical Mycology
  • Pharmacology
  • Skeletal Radiology

Background:

  • Voriconazole is an antifungal medication frequently used in immunocompromised patients.
  • Diffuse periostitis is a known, albeit rare, adverse effect associated with voriconazole therapy.
  • This condition is particularly noted in transplant recipients and those on long-term immunosuppression.

Observation:

  • A 66-year-old lung transplant recipient developed progressive, diffuse bone pain over one year.
  • The patient was on prophylactic low-dose voriconazole for pulmonary aspergillosis for over seven years.
  • Radiographic findings revealed multifocal periostitis, consistent with voriconazole-induced periostitis deformans.

Findings:

  • Elevated alkaline phosphatase and bone-specific alkaline phosphatase levels were observed.
  • Discontinuation of voriconazole led to symptomatic improvement in the patient.
  • Radiographic bone deformities persisted despite clinical recovery.

Implications:

  • Voriconazole-induced periostitis should be considered in immunosuppressed patients presenting with diffuse bone pain.
  • Early diagnosis can prevent unnecessary investigations and improve patient outcomes.
  • This condition, linked to skeletal fluorosis, is generally reversible upon drug cessation.