Voriconazole-induced psychosis in rhino-orbital invasive aspergillosis

BMJ Case Rep. 2023 Oct 11;16(10):e254790. doi: 10.1136/bcr-2023-254790.

Abstract

Aspergillosis is a challenging fungal infection. Voriconazole is an antifungal drug belonging to the triazole group, commonly used for treating invasive aspergillosis, Cryptococcus neoformans and candida infections. We present a case of a man in his late 70s diagnosed with rhino-orbital invasive aspergillosis who developed voriconazole-induced psychosis as an idiosyncratic, adverse drug reaction (ADR); however, he responded to the cessation of intravenous voriconazole and, after starting on an oral antipsychotic, haloperidol. Clinicians need to be cognizant of this rare, idiosyncratic and iatrogenic ADR to voriconazole.

Keywords: Ear, nose and throat/otolaryngology; Psychiatry.

Publication types

  • Case Reports

MeSH terms

  • Antifungal Agents / adverse effects
  • Aspergillosis* / drug therapy
  • Aspergillosis* / microbiology
  • Humans
  • Invasive Fungal Infections* / drug therapy
  • Male
  • Psychotic Disorders* / drug therapy
  • Pyrimidines / therapeutic use
  • Voriconazole / adverse effects

Substances

  • Voriconazole
  • Pyrimidines
  • Antifungal Agents