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August 16th, 2024A 62-year-old man comes to the emergency department with a 3-day history of worsening cough and new onset hemoptysis. He has had an intermittent cough since 3 months ago. His medical history includes previous pulmonary tuberculosis treated successfully 5 years ago. Drug history includes only pantoprazole for gastroesophageal reflux symptoms. His temperature is 37.4 °C (99.32 °F), pulse is 85/min, respiratory rate is 19/min, blood pressure is 120/90 mm, and SpO2 is 96% on room air. Physical examination shows no distress and decreased breath sounds to auscultation. CT chest shows cavitations and a fungal ball. Laboratory testing shows elevated Aspergillus IgG antibodies. Antifungal therapy with voriconazole is started. Which of the following adverse reactions occurs most often with this class of medication?