Voriconazole-associated periostitis: Pathophysiology, risk factors, clinical manifestations, diagnosis, and management
Anthony J. Guarascio, Nitin Bhanot, Zaw Min
Abstract
Voriconazole use has been associated with osteoarticular pain and periostitis, likely due to high fluoride content in the drug formulation. This phenomenon has been described primarily with high dosage or prolonged course of voriconazole therapy in immunocompromised and transplant patient populations. Patients typically present with diffuse bony pains associated with elevated serum alkaline phosphatase and plasma fluoride levels in conjunction with radiographic findings suggestive of periostitis. We provide a comprehensive review of the literature to highlight salient characteristics commonly associated with voriconazole-induced periostitis.
Topics & Concepts
PeriostitisMedicinePathophysiologyIntensive care medicineVoriconazoleDermatologyPathologyAntifungalAntifungal resistance and susceptibilityLegionella and Acanthamoeba researchMedical and Biological Ozone Research