posted on 2022-03-23, 15:17authored byOrla M. Murray, John P. Hynes, Michelle A . Murray, Eoin C Kavanagh
Voriconazole is a broad-spectrum triazole antifungal used to treatinvasive fungal infections.
It is commonly used prophylactically in immunocompromized patient cohorts, including
transplant recipients. Diffuse periostitis is a very rare complication of chronic voricona zole use. It is associated with diffuse bone pain, elevated serum alkaline phosphatase and
fluorine levels. Characteristic imaging findings include periosteal thickening with a dense,
nodular, irregular and often bilateral pattern. We describe the case of a 71-year-old female
who presented with multifocal bone pain six years following double lung transplantation.
Her post transplantation course had been complicated by a life threatening episode of sepsis
secondary to Scedosporium apiospermum, a rare invasive fungal infection following which
lifelong prophylaxis with oral Voriconazole was commenced. We discuss the characteristic
clinical and imaging manifestations of this rare condition.