Agrawal A K, Sherman L K
Baylor College of Medicine, Houston, Texas, USA.
Infection. 2004 Oct;32(5):293-5. doi: 10.1007/s15010-004-3121-1.
1 Voriconazole (Vfend) is a second-generation azole antifungal that is increasing in popularity especially for the treatment of invasive aspergillosis as well as empirically for the febrile neutropenic patient. In addition, voriconazole tends to have a mild side effect profile with reversible visual disturbances being the most widely described effect. We describe a patient who had musical hallucinations secondary to voriconazole. The patient was a 78-year-old man admitted for induction of chemotherapy for acute myelogenous leukemia (AML) who began to have auditory hallucinations, specifically of Christmas music, the 2nd day of voriconazole therapy. His psychiatric evaluation was otherwise unremarkable. After discontinuing voriconazole the hallucinations decreased in intensity by the 2nd day and ceased altogether by the 3rd day. An extensive literature search, including Pfizer drug trial safety data, yielded no other reports of auditory hallucinations with voriconazole. Several other interesting cases of musical hallucinations secondary to a variety of causes have been reported in the literature, and are reviewed. Notably, musical hallucinations tend to occur secondary to temporal lobe insults and often are of a religious or patriotic theme.
1 伏立康唑（威凡）是第二代唑类抗真菌药，其应用日益广泛，尤其用于治疗侵袭性曲霉病以及作为发热性中性粒细胞减少患者的经验性用药。此外，伏立康唑的副作用往往较轻，其中可逆性视觉障碍是描述最为广泛的不良反应。我们报告了1例继发于伏立康唑的音乐幻觉患者。该患者为一名78岁男性，因急性髓系白血病（AML）入院接受化疗诱导治疗，在伏立康唑治疗第2天开始出现幻听，具体为圣诞音乐。其精神科评估未见其他异常。停用伏立康唑后，幻觉强度在第2天有所减轻，第3天完全消失。广泛的文献检索，包括辉瑞药物试验安全数据，未发现其他关于伏立康唑致幻听的报告。文献中还报道了其他几例继发于各种原因的有趣的音乐幻觉病例，并进行了综述。值得注意的是，音乐幻觉往往继发于颞叶损伤，且常具有宗教或爱国主题。
