Voriconazole-induced periostitis in two post-transplant patients.

Abstract

While drug-related periostitis has been known of for many years, the specific association of diffuse periostitis with voriconazole (most frequently in transplant patients) has only been recently explicitly addressed in the literature. Recognition of the radiologic and clinical manifestations of voriconazole-related periostitis is important for helping to narrow an otherwise broad differential diagnosis. We present two cases that illustrate different radiologic presentations of this painful cause of diffuse periostitis. Case 1 features a 60 year-old woman with a history of orthotopic heart transplant who was hospitalized for "full body pain" with progressively worsening bone tenderness involving the humeri, knees, femurs, hips, and hands. Case 2 describes a 48 year-old man with a history of acute lymphoblastic leukemia status post stem cell transplant who presented with diffuse arthralgias involving bilateral ankles, knees, wrists, and elbows.

• Authors: Matthew D Bucknor, Andrew J Gross, Thomas M Link
• Journal: Journal of radiology case reports (J Radiol Case Rep) Vol. 7 Issue 8 Pg. 10-7 (Aug 2013) ISSN: 1943-0922 [Electronic] United States
• PMID: 24421948 (Publication Type: Case Reports, Journal Article)

Chemical References

• Antifungal Agents
• Pyrimidines
• Radiopharmaceuticals
• Triazoles
• Voriconazole
• Technetium Tc 99m Medronate

Topics

• Antifungal Agents (adverse effects)
• Female
• Heart Transplantation
• Humans
• Male
• Middle Aged
• Opportunistic Infections (complications, drug therapy)
• Periostitis (chemically induced, diagnostic imaging)
• Precursor Cell Lymphoblastic Leukemia-Lymphoma (therapy)
• Pulmonary Aspergillosis (complications, drug therapy)
• Pyrimidines (adverse effects)
• Radionuclide Imaging
• Radiopharmaceuticals
• Stem Cell Transplantation
• Technetium Tc 99m Medronate
• Tomography, X-Ray Computed
• Triazoles (adverse effects)
• Voriconazole