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Clin Nucl Med. 2018 Dec 3. doi: 10.1097/RLU.0000000000002383. [Epub ahead of print]

Voriconazole-Induced Periostitis After Allogeneic Stem Cell Transplantation.

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From the Departments of Nuclear Medicine and Molecular Imaging, and.


A 34-year-old man with history of Hodgkin lymphoma presented 7 months after allogeneic stem cell transplantation with an unexplained severe musculoskeletal pain syndrome. A Tc-MDP bone SPECTCT showed multiple foci with moderate to intense bone uptake across the axial and appendicular skeleton consistent with periostitis. The patient had been on voriconazole daily for 4 months to treat an Aspergillus pneumonia, and in the absence of other causes, a drug-induced periostitis was suspected. Voriconazole was changed to posaconazole with complete resolution of the musculoskeletal symptoms within 3 weeks.

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