Voriconazole induced periostitis

Abstract

Voriconazole is a second generation broad spectrum triazole antifungal agent which is commonly used for prophylaxis and treatment of invasive aspergillosis, especially in patients with solid organ and hematopoietic stem cell transplants. One of the rare, adverse effects of long-term use is periostitis which is caused by increased circulating levels of fluoride from voriconazole metabolism with clinical findings similar to skeletal fluorosis. Given the increased use of voriconazole, it is essential to recognize periostitis as an adverse effect with prompt discontinuation of the medication improving patient outcomes and quality of life.