%0 Case Reports
%T Voriconazole-induced periostitis in a patient with HIV treated for coccidioidomycosis meningitis.
%A Nguyen QP
%A Wooten D
%J BMJ Case Rep
%V 17
%N 1
%D 2024 Jan 25
%M 38272516
暂无%R 10.1136/bcr-2023-257884
%X 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.