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Voriconazole-induced periostitis in a patient with HIV treated for coccidioidomycosis meningitis
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Voriconazole-induced periostitis in a patient with HIV treated for coccidioidomycosis meningitis
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Journal Article
Voriconazole-induced periostitis in a patient with HIV treated for coccidioidomycosis meningitis
2024
Overview
Voriconazole-induced periostitis is a rare adverse effect in patients on long-term therapy, characterised by periosteal inflammation and associated bony pain. The accompanying lab abnormalities (elevated serum alkaline phosphatase and fluoride) and characteristic imaging findings (uptake of radionuclide tracer on nuclear bone scan) are critical for diagnosis. The disease process is thought to be secondary to excess fluoride from voriconazole which stimulates bone formation and decreases osteoclast bone resorption. Management includes stopping voriconazole and switching to another agent.
Publisher
BMJ Publishing Group Ltd,BMJ Publishing Group LTD
Subject
/ Antifungal Agents - adverse effects
/ Blood
/ Bones
/ Coccidioidomycosis - diagnosis
/ Coccidioidomycosis - drug therapy
/ HIV
/ HIV Infections - drug therapy
/ Human immunodeficiency virus
/ Humans
/ Pain
/ Patients
/ Periostitis - chemically induced
/ Periostitis - diagnostic imaging
/ Syphilis
