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  Vol. 62 No. 1, January 2005 TABLE OF CONTENTS
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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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