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Voriconazole-Associated Periostitis: New Insights into Pathophysiology and Management.

1. Introduction Voriconazole is a frequently used antifungal in the post-transplant setting and has been associated with periostitis with long-term use.( 1 ) The true prevalence of voriconazole-associated periostitis (VAP) is unknown; however, retrospective studies suggest this adverse effect may occur in up to 15% of patients on voriconazole.( 1 , 2 , 3 ) Risk factors for developing VAP are poorly understood, and treatment options are limited. VAP shares common clinical features with sub