“Crocus Flower”: Voriconazole-Induced Hallucinations and Visual Disturbances in a Patient with Recurrent Severe Vulvovaginitis—A Case Report on Irrational Drug Use

TL;DR

A patient experienced hallucinations and visual issues after receiving voriconazole, highlighting the risks of improper drug use and the importance of clinical pharmacist guidance.

Contribution

Highlights irrational drug use and infusion rate as potential causes of voriconazole-induced visual disturbances.

Findings

A patient developed hallucinations and visual impairments after initial intravenous voriconazole administration.

Symptoms resolved after adjusting the dosage and infusion rate per clinical pharmacist recommendations.

The case underscores the importance of proper infusion protocols to prevent adverse effects.

Abstract

Background and Clinical Significance: Voriconazole is a commonly prescribed second-generation azole used for the prevention and treatment of fungal infections. This report seeks to elucidate the relationship between certain intravenous infusion parameters and the causality and severity of potential visual adverse events associated with voriconazole administration, despite existing reports of visual disturbances such as hallucinations and altered visual perception, the underlying causes of which remain inadequately understood. Case Presentation: This case report describes a 32-year-old female patient who experienced sudden hallucinations and visual impairments after receiving an initial dose of intravenous voriconazole for the treatment of recurrent severe vulvovaginitis caused by Candida glabrata. The symptoms quickly disappeared when the dosage and infusion rate were reduced as per the recommendations of the clinical pharmacist. Conclusions: This example emphasizes the possible negative drug responses linked to voriconazole, especially those provoked by its irrational use described as an inappropriate infusion rate, and the crucial role of clinical pharmacists in recognizing and handling these reactions.

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