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Case Reports: Adverse drug reactions and complications
Voriconazole-induced psychosis in rhino-orbital invasive aspergillosis
  1. H Swarna Rekha1,2,
  2. Sabharisan Paramasivam3,
  3. Kalaiarasi Raja3 and
  4. Balaji Bharadwaj1
  1. 1Department of Psychiatry, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
  2. 2Department of Psychiatry, NIMHANS, Bangalore, Karnataka, India
  3. 3Department of ENT, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
  1. Correspondence to Dr Balaji Bharadwaj; balaji{at}jipmer.ac.in

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.

  • Ear, nose and throat/otolaryngology
  • Psychiatry

https://doi.org/10.1136/bcr-2023-254790

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    Footnotes

    • Contributors The following authors were responsible for drafting of the text, sourcing and editing of clinicalimages, investigation results, drawing original diagrams and algorithms, and critical revision forimportant intellectual content: HSR, SP, KR and BB. HSR and SP prepared the initial draft including the relevant clinical images. BB and KR reviewed and edited the initial draft. The following authors gave final approval of the manuscript: all authors .

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.