Voriconazole Induced Periostitis in a Patient with ANCA Vasculitis: A Case Report

摘要

A 62 year-old gentleman with underlying ANCA vasculitis was admitted to hospital for severe musculoskeletal pain involving both shoulders, hips and hands. There was a history of long term usage of anti-fungal medica-tion-voriconazole for his Aspergillus fumigatus lung infection as treatment and prophylaxis. Clinically the range of movement of both shoulders and hips was restricted with the presence of digital swelling of both hands. His imaging findings noted the presence of periosteal reaction involving shoulders and hips in addition to increased radiotracer uptake on his bone scan. A diagnosis of voriconaz ole induced periostitis was made and dis-continuation of therapy led to rapid clinical improvement.