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Painful Peripheral Neuropathy Associated With Voriconazole Use
Sotirios Tsiodras, MD, ScD;
Rodesa Zafiropoulou, MD;
Efthymia Kanta, MD;
Christos Demponeras, MD;
Nikos Karandreas, MD;
Emanuel K. Manesis, MD
Arch Neurol. 2005;62:144-146.
Background Voriconazole is a new antifungal agent that has been recently introduced into clinical practice. We found no published reports of painful peripheral neuropathy associated with its use.
Objective To describe a unique case of painful peripheral neuropathy associated with voriconazole use.
Setting University hospital.
Patient A 43-year-old patient who had undergone liver transplantation received voriconazole for invasive deep sinus aspergillosis and developed intolerable pain in all extremities.
Results A laboratory workup and electromyographic and nerve conduction studies were performed to exclude other causes of neuropathy in this complicated patient. Results of electromyographic and nerve conduction studies were suggestive of a demyelinating neuropathy. Symptoms and signs of neuropathy disappeared shortly after voriconazole discontinuation, suggesting a possible role in the development of neuropathy. The patient continues to do well 10 months after this event.
Conclusions To our knowledge, this is the first reported case of voriconazole-associated peripheral neuropathy. Awareness of this association and careful monitoring for neurological signs are necessary for patients receiving voriconazole.
Author Affiliations: Academic Department of Medicine, Hippokration General Hospital (Drs Tsiodras, Zafiropoulou, Kanta, Demponeras, and Manesis), and Laboratory of Electromyography, Department of Neurology, University of Athens Medical School (Dr Karandreas), Athens, Greece.
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