title: Multifocal periostitis as a complication of chronic use of voriconazole in a lung transplant recipient.
abstract: Fungal infections are common in solid organ transplantation. An increasing number of transplant recipients receive antifungal therapy for prolonged duration owing to invasive fungal infections. Herein, we describe a diagnosis of periostitis as a complication of chronic use of voriconazole in a lung transplant recipient. The patient was diagnosed with probable pulmonary aspergillosis and was treated with oral voriconazole for a total of 9 months. Evidence of multifocal periostitis was observed in the axial and appendicular skeleton. Early recognition of this phenomenon is important to prevent unnecessary tests and procedures. Prompt discontinuation of voriconazole should result in improvement of symptoms.
authors.affiliation: Department of Infectious Disease, Cleveland Clinic Foundation, Cleveland, Ohio 44195, USA. tedjar@ccf.org
authors.forename: R
authors.initials: R
authors.lastname: Tedja
authors.forename: A
authors.initials: A
authors.lastname: El-Sherief
authors.forename: T
authors.initials: T
authors.lastname: Olbrych
authors.forename: S
authors.initials: S
authors.lastname: Gordon
mesh_terms: D000368:Aged; D000935:Antifungal Agents / Q000009:adverse effects* / Q000627:therapeutic use; D018890:Chemoprevention; D005260:Female; D006801:Humans; D008172:Lung Diseases, Fungal / Q000150:complications / Q000188:drug therapy* / Q000382:microbiology; D016040:Lung Transplantation / Q000009:adverse effects*; D008297:Male; D010522:Periostitis / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology*; D055732:Pulmonary Aspergillosis / Q000150:complications / Q000188:drug therapy* / Q000382:microbiology; D011743:Pyrimidines / Q000009:adverse effects* / Q000627:therapeutic use; D014230:Triazoles / Q000009:adverse effects* / Q000627:therapeutic use; D065819:Voriconazole
chemical_list: D000935:Antifungal Agents; D011743:Pyrimidines; D014230:Triazoles; D065819:Voriconazole
keywords: hypertrophic osteoarthropathy; periostitis; solid organ transplants; voriconazole