Reber Joshua D, McKenzie Gavin A, Broski Stephen M
Department of Radiology, Mayo Clinic, 200 1st St. SW, Rochester, MN, 55905, USA.
Skeletal Radiol. 2016 Jun;45(6):839-42. doi: 10.1007/s00256-016-2365-z. Epub 2016 Mar 15.
Voriconazole-induced periostitis (VIP) is a rare but increasingly encountered entity since Food and Drug Administration (FDA) approval of the second generation antifungal medication in 2002. Literature reports most commonly include transplant recipients on immunosuppressive therapy simultaneously requiring antifungal therapy. Nontransplant patients receiving long-term voriconazole have an equal risk of developing the disease, but may experience a delay in diagnosis due to a lack of familiarity with the process outside of the post-transplant and/or immunosuppressed population. We present a case of VIP in a nontransplant, immunocompetent patient on suppressive antifungal therapy for prior abdominal aortic stent graft fungal infection. Radiologist review of current medications and recognition of periostitis on multiple imaging modalities may hasten the diagnosis and lead to earlier treatment and resolution of symptoms.
伏立康唑诱导的骨膜炎（VIP）是一种罕见但自2002年美国食品药品监督管理局（FDA）批准第二代抗真菌药物以来越来越常见的病症。文献报道中最常见的是同时接受免疫抑制治疗和抗真菌治疗的移植受者。接受长期伏立康唑治疗的非移植患者患此病的风险相同，但由于对移植后和/或免疫抑制人群以外的情况缺乏了解，可能会出现诊断延迟。我们报告一例非移植、免疫功能正常的患者，因先前腹主动脉支架移植物真菌感染接受抑制性抗真菌治疗而发生VIP。放射科医生对当前用药情况进行审查，并通过多种成像方式识别骨膜炎，可能会加快诊断速度，并导致症状得到更早的治疗和缓解。
