Neurologic Adverse Events Associated with Voriconazole Therapy: Report of Two Pediatric Cases

Although voriconazole, a triazole antifungal, is a safe drug, treatment with this agent is associated with certain adverse events such as hepatic, neurologic, and visual disturbances. The current report presents two cases, one a 9-year-old boy and the other a 17-year-old girl, who experienced neurol...

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Main Authors: Sevliya Öcal Demir, Serkan Atici, Gülşen Akkoç, Nurhayat Yakut, Nilay Baş İkizoğlu, Ela Erdem Eralp, Ahmet Soysal, Mustafa Bakir
Format: Article
Language:English
Published: Wiley 2016-01-01
Series:Case Reports in Infectious Diseases
Online Access:http://dx.doi.org/10.1155/2016/3989070
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author Sevliya Öcal Demir
Serkan Atici
Gülşen Akkoç
Nurhayat Yakut
Nilay Baş İkizoğlu
Ela Erdem Eralp
Ahmet Soysal
Mustafa Bakir
author_facet Sevliya Öcal Demir
Serkan Atici
Gülşen Akkoç
Nurhayat Yakut
Nilay Baş İkizoğlu
Ela Erdem Eralp
Ahmet Soysal
Mustafa Bakir
author_sort Sevliya Öcal Demir
collection DOAJ
description Although voriconazole, a triazole antifungal, is a safe drug, treatment with this agent is associated with certain adverse events such as hepatic, neurologic, and visual disturbances. The current report presents two cases, one a 9-year-old boy and the other a 17-year-old girl, who experienced neurologic side effects associated with voriconazole therapy. Our aim is to remind readers of the side effects of voriconazole therapy in order to prevent unnecessary investigations especially for psychological and ophthalmologic problems. The first case was a 9-year-old boy with cystic fibrosis and invasive aspergillosis that developed photophobia, altered color sensation, and fearful visual hallucination. The second case was a 17-year-old girl with cystic fibrosis and allergic bronchopulmonary aspergillosis, and she experienced photophobia, fatigue, impaired concentration, and insomnia, when the dose of voriconazole therapy was increased from 12 mg/kg/day to 16 mg/kg/day. The complaints of the two patients disappeared after discontinuation of voriconazole therapy. Our experience in these patients reminded us of the importance of being aware of the neurologic adverse events associated with voriconazole therapy in establishing early diagnosis and initiating prompt treatment. In addition, although serum voriconazole concentration was not measured in the present cases, therapeutic drug monitoring for voriconazole seems to be critically important in preventing neurologic side effects in pediatric patients.
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spelling doaj-art-213e4c519b794f4e99f6b841a29abc9b2025-08-20T03:54:47ZengWileyCase Reports in Infectious Diseases2090-66252090-66332016-01-01201610.1155/2016/39890703989070Neurologic Adverse Events Associated with Voriconazole Therapy: Report of Two Pediatric CasesSevliya Öcal Demir0Serkan Atici1Gülşen Akkoç2Nurhayat Yakut3Nilay Baş İkizoğlu4Ela Erdem Eralp5Ahmet Soysal6Mustafa Bakir7Marmara University School of Medicine, Department of Pediatrics, Division of Pediatric Infectious Diseases, 34912 Istanbul, TurkeyMarmara University School of Medicine, Department of Pediatrics, Division of Pediatric Infectious Diseases, 34912 Istanbul, TurkeyMarmara University School of Medicine, Department of Pediatrics, Division of Pediatric Infectious Diseases, 34912 Istanbul, TurkeyMarmara University School of Medicine, Department of Pediatrics, Division of Pediatric Infectious Diseases, 34912 Istanbul, TurkeyMarmara University School of Medicine, Department of Pediatrics, Division of Pediatric Pulmonology, 34912 Istanbul, TurkeyMarmara University School of Medicine, Department of Pediatrics, Division of Pediatric Pulmonology, 34912 Istanbul, TurkeyMarmara University School of Medicine, Department of Pediatrics, Division of Pediatric Infectious Diseases, 34912 Istanbul, TurkeyMarmara University School of Medicine, Department of Pediatrics, Division of Pediatric Infectious Diseases, 34912 Istanbul, TurkeyAlthough voriconazole, a triazole antifungal, is a safe drug, treatment with this agent is associated with certain adverse events such as hepatic, neurologic, and visual disturbances. The current report presents two cases, one a 9-year-old boy and the other a 17-year-old girl, who experienced neurologic side effects associated with voriconazole therapy. Our aim is to remind readers of the side effects of voriconazole therapy in order to prevent unnecessary investigations especially for psychological and ophthalmologic problems. The first case was a 9-year-old boy with cystic fibrosis and invasive aspergillosis that developed photophobia, altered color sensation, and fearful visual hallucination. The second case was a 17-year-old girl with cystic fibrosis and allergic bronchopulmonary aspergillosis, and she experienced photophobia, fatigue, impaired concentration, and insomnia, when the dose of voriconazole therapy was increased from 12 mg/kg/day to 16 mg/kg/day. The complaints of the two patients disappeared after discontinuation of voriconazole therapy. Our experience in these patients reminded us of the importance of being aware of the neurologic adverse events associated with voriconazole therapy in establishing early diagnosis and initiating prompt treatment. In addition, although serum voriconazole concentration was not measured in the present cases, therapeutic drug monitoring for voriconazole seems to be critically important in preventing neurologic side effects in pediatric patients.http://dx.doi.org/10.1155/2016/3989070
spellingShingle Sevliya Öcal Demir
Serkan Atici
Gülşen Akkoç
Nurhayat Yakut
Nilay Baş İkizoğlu
Ela Erdem Eralp
Ahmet Soysal
Mustafa Bakir
Neurologic Adverse Events Associated with Voriconazole Therapy: Report of Two Pediatric Cases
Case Reports in Infectious Diseases
title Neurologic Adverse Events Associated with Voriconazole Therapy: Report of Two Pediatric Cases
title_full Neurologic Adverse Events Associated with Voriconazole Therapy: Report of Two Pediatric Cases
title_fullStr Neurologic Adverse Events Associated with Voriconazole Therapy: Report of Two Pediatric Cases
title_full_unstemmed Neurologic Adverse Events Associated with Voriconazole Therapy: Report of Two Pediatric Cases
title_short Neurologic Adverse Events Associated with Voriconazole Therapy: Report of Two Pediatric Cases
title_sort neurologic adverse events associated with voriconazole therapy report of two pediatric cases
url http://dx.doi.org/10.1155/2016/3989070
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