Multifocal periostitis as a complication of chronic use of voriconazole in a lung transplant recipient

Transpl Infect Dis. 2013 Aug;15(4):424-9. doi: 10.1111/tid.12088. Epub 2013 May 13.

Abstract

Fungal infections are common in solid organ transplantation. An increasing number of transplant recipients receive antifungal therapy for prolonged duration owing to invasive fungal infections. Herein, we describe a diagnosis of periostitis as a complication of chronic use of voriconazole in a lung transplant recipient. The patient was diagnosed with probable pulmonary aspergillosis and was treated with oral voriconazole for a total of 9 months. Evidence of multifocal periostitis was observed in the axial and appendicular skeleton. Early recognition of this phenomenon is important to prevent unnecessary tests and procedures. Prompt discontinuation of voriconazole should result in improvement of symptoms.

Keywords: hypertrophic osteoarthropathy; periostitis; solid organ transplants; voriconazole.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Aged
  • Antifungal Agents / adverse effects*
  • Antifungal Agents / therapeutic use
  • Chemoprevention
  • Female
  • Humans
  • Lung Diseases, Fungal / complications
  • Lung Diseases, Fungal / drug therapy*
  • Lung Diseases, Fungal / microbiology
  • Lung Transplantation / adverse effects*
  • Male
  • Periostitis / complications
  • Periostitis / diagnosis
  • Periostitis / drug therapy
  • Periostitis / microbiology*
  • Pulmonary Aspergillosis / complications
  • Pulmonary Aspergillosis / drug therapy*
  • Pulmonary Aspergillosis / microbiology
  • Pyrimidines / adverse effects*
  • Pyrimidines / therapeutic use
  • Triazoles / adverse effects*
  • Triazoles / therapeutic use
  • Voriconazole

Substances

  • Antifungal Agents
  • Pyrimidines
  • Triazoles
  • Voriconazole