Abstract | BACKGROUND: METHODS: Two hundred sixty-four patients from Michigan were impacted by the multistate outbreak of fungal infections as a result of contaminated methylprednisolone injections. A retrospective study was conducted among 195 patients who received voriconazole therapy at St Joseph Mercy Hospital during this outbreak. Twenty-eight patients who received both bone scan and plasma fluoride measurements for skeletal pain were included in the statistical analyses. Increased tracer uptake on bone scan was considered positive for periostitis. The primary outcome measure was the correlation between plasma fluoride and bone scan results. RESULTS: CONCLUSIONS: High plasma fluoride levels coupled with skeletal pain among patients who are on long-term voriconazole therapy is highly suggestive of periostitis. Initial measurement of fluoride may be considered when bone scan is not readily available. Early detection should be sought, as discontinuation of voriconazole is effective at reversing the disease.
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Authors | Woo J Moon, Erica L Scheller, Anupam Suneja, Jacob A Livermore, Anurag N Malani, Varsha Moudgal, Lisa E Kerr, Eric Ferguson, David M Vandenberg |
Journal | Clinical infectious diseases : an official publication of the Infectious Diseases Society of America
(Clin Infect Dis)
Vol. 59
Issue 9
Pg. 1237-45
(Nov 01 2014)
ISSN: 1537-6591 [Electronic] United States |
PMID | 24992954
(Publication Type: Journal Article)
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Copyright | © The Author 2014. Published by Oxford University Press on behalf of the Infectious Diseases Society of America. All rights reserved. For Permissions, please e-mail: [email protected]. |
Chemical References |
- Alkaline Phosphatase
- Voriconazole
- Fluorides
- Methylprednisolone
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Topics |
- Adult
- Aged
- Aged, 80 and over
- Alkaline Phosphatase
- Drug Contamination
- Female
- Fluorides
(blood)
- Humans
- Male
- Methylprednisolone
- Middle Aged
- Pain
(etiology)
- Periostitis
(chemically induced, epidemiology)
- Retrospective Studies
- Voriconazole
(adverse effects)
- Whole Body Imaging
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