Zheng Rujiang, Li Yu, Guo Chuyi, Pei Yuxin, Ke Zhiyong, Huang Libin
Department of Pediatrics, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China.
Front Pediatr. 2021 Apr 23;9:655327. doi: 10.3389/fped.2021.655327. eCollection 2021.
Voriconazole is a second-generation azole widely used for the prevention and treatment of fungal infection in leukemia patients. We report a case of 9-year-old girl with T-cell acute lymphoblastic leukemia who developed hallucinations and visual disturbance after using voriconazole twice. These symptoms began acutely after treatment with voriconazole and resolved rapidly when the voriconazole was stopped. No specific cause was identified, and thus the symptoms were considered to be the adverse drug reactions (ADRs) of voriconazole. Simultaneous development of hallucinations and visual disturbance caused by voriconazole in children rarely have been reported before and the causes of these ADRs are unknown. Several other cases of hallucinations and (or) visual disturbance caused by voriconazole among 15-81 years old patients have been reported in the literature, and are reviewed. Those patients reminded us of the importance of being aware of hallucinations and visual disturbance associated with voriconazole treatment. In addition, we speculate that the hallucinations and visual disturbance are not related to the dosage form of voriconazole. We emphasize that it is also important to monitor the concentration of voriconazole regularly to avoid potential toxicity.
伏立康唑是一种第二代唑类药物，广泛用于白血病患者真菌感染的预防和治疗。我们报告了一例9岁患T细胞急性淋巴细胞白血病的女孩，在两次使用伏立康唑后出现幻觉和视觉障碍。这些症状在伏立康唑治疗后急性起病，停用伏立康唑后迅速缓解。未发现具体病因，因此这些症状被认为是伏立康唑的药物不良反应（ADR）。伏立康唑同时引起儿童幻觉和视觉障碍此前鲜有报道，且这些ADR的病因不明。文献中还报道了其他几例15 - 81岁患者由伏立康唑引起的幻觉和（或）视觉障碍，并进行了综述。这些患者提醒我们注意与伏立康唑治疗相关的幻觉和视觉障碍的重要性。此外，我们推测幻觉和视觉障碍与伏立康唑的剂型无关。我们强调定期监测伏立康唑浓度以避免潜在毒性也很重要。
