Voriconazole-Induced Photosensitivity in Children: A Case Report and Literature Review.

Abstract

Voriconazole is a broad-spectrum triazole antifungal with a reliable oral bioavailability introduced in 2002. It is indicated for treatment of pulmonary aspergillosis, primary treatment of amphotericin B and fluconazole-resistant fungal infections such as Fusarium spp and Scedosporium apiospermum (asexual form of Pseudoallescheria boydii).1,2 Voriconazole is also used for empirical antifungal therapy of neutropenic fever in patients receiving nephrotoxins (cyclosporine, tacrolimus) and antifungal prophylaxis in high-risk patients undergoing bone marrow transplantation and patients with severe graft-versus-host disease.1,2 Common side effects include abnormal vision, elevation of liver enzymes, as well as skin rashes including allergic reactions and Stevens–Johnson syndrome.1 Metabolic side effects include hypokalemia and hypomagnesemia. Photosensitivity is a rare complication of voriconazole therapy3; a limited number of cases have been reported in the pediatric population.4-12 We report a teenager with common variable immunodeficiency who developed voriconazole-induced severe photosensitivity reaction mimicking Stevens–Johnson syndrome requiring treatment in the burn unit with frequent dressing changes for 2 days.