Cargando…

A Case of Levofloxacin-Induced Hepatotoxicity

Patient: Male, 36 Final Diagnosis: Levofloxacin-induced hepatotoxicity Symptoms: Cellulitis • pain Medication: Levofloxacin Clinical Procedure: — Specialty: Infectious Diseases OBJECTIVE: Unusual clinical course BACKGROUND: Levofloxacin covers a broad spectrum of pathogens and is readily prescribed...

Descripción completa

Detalles Bibliográficos
Autores principales: Schloss, Michael, Becak, Daniel, Tosto, Sebastian T., Velayati, Arash
Formato: Online Artículo Texto
Lenguaje:English
Publicado: International Scientific Literature, Inc. 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5859667/
https://www.ncbi.nlm.nih.gov/pubmed/29523775
http://dx.doi.org/10.12659/AJCR.907440
_version_ 1783307868894658560
author Schloss, Michael
Becak, Daniel
Tosto, Sebastian T.
Velayati, Arash
author_facet Schloss, Michael
Becak, Daniel
Tosto, Sebastian T.
Velayati, Arash
author_sort Schloss, Michael
collection PubMed
description Patient: Male, 36 Final Diagnosis: Levofloxacin-induced hepatotoxicity Symptoms: Cellulitis • pain Medication: Levofloxacin Clinical Procedure: — Specialty: Infectious Diseases OBJECTIVE: Unusual clinical course BACKGROUND: Levofloxacin covers a broad spectrum of pathogens and is readily prescribed by clinicians. Hepatotoxicity is a known but unusual complication of levofloxacin use. Here, we present a case of severe transaminitis caused by levofloxacin. CASE REPORT: A young man in his thirties with a history of asthma, chronic alcoholism, methamphetamine intravenous drug abuse (IVDA), and non-compliant insulin-dependent diabetes mellitus (IDDM) presented to an emergency department with suicidal ideation. Vital signs were stable and the patient was noted to have cellulitis of the right forearm, for which cultures were drawn, and he received IV clindamycin. He was admitted to behavioral medicine for further care. Blood cultures were positive for gram-negative rods and he was transferred to the medicine ward. Cultures eventually grew Brevundimonas diminuta. Clindamycin was discontinued and he was started on levofloxacin. Transaminase levels measured soon after levofloxacin administration showed aminotransferase levels raised to approximately 50 times baseline within a few days. Levofloxacin was discontinued due to concern about drug-induced hepatotoxicity. After discontinuation, transaminase levels decreased immediately. Work-up for other causes of transaminitis revealed no other etiology. CONCLUSIONS: Clinicians should remain mindful that levofloxacin can induce hepatotoxicity in rare cases. In patients presenting with acute liver injury who have recently taken levofloxacin, it would be wise to remain cognizant of the possibility of levofloxacin-induced hepatotoxicity.
format Online
Article
Text
id pubmed-5859667
institution National Center for Biotechnology Information
language English
publishDate 2018
publisher International Scientific Literature, Inc.
record_format MEDLINE/PubMed
spelling pubmed-58596672018-03-21 A Case of Levofloxacin-Induced Hepatotoxicity Schloss, Michael Becak, Daniel Tosto, Sebastian T. Velayati, Arash Am J Case Rep Articles Patient: Male, 36 Final Diagnosis: Levofloxacin-induced hepatotoxicity Symptoms: Cellulitis • pain Medication: Levofloxacin Clinical Procedure: — Specialty: Infectious Diseases OBJECTIVE: Unusual clinical course BACKGROUND: Levofloxacin covers a broad spectrum of pathogens and is readily prescribed by clinicians. Hepatotoxicity is a known but unusual complication of levofloxacin use. Here, we present a case of severe transaminitis caused by levofloxacin. CASE REPORT: A young man in his thirties with a history of asthma, chronic alcoholism, methamphetamine intravenous drug abuse (IVDA), and non-compliant insulin-dependent diabetes mellitus (IDDM) presented to an emergency department with suicidal ideation. Vital signs were stable and the patient was noted to have cellulitis of the right forearm, for which cultures were drawn, and he received IV clindamycin. He was admitted to behavioral medicine for further care. Blood cultures were positive for gram-negative rods and he was transferred to the medicine ward. Cultures eventually grew Brevundimonas diminuta. Clindamycin was discontinued and he was started on levofloxacin. Transaminase levels measured soon after levofloxacin administration showed aminotransferase levels raised to approximately 50 times baseline within a few days. Levofloxacin was discontinued due to concern about drug-induced hepatotoxicity. After discontinuation, transaminase levels decreased immediately. Work-up for other causes of transaminitis revealed no other etiology. CONCLUSIONS: Clinicians should remain mindful that levofloxacin can induce hepatotoxicity in rare cases. In patients presenting with acute liver injury who have recently taken levofloxacin, it would be wise to remain cognizant of the possibility of levofloxacin-induced hepatotoxicity. International Scientific Literature, Inc. 2018-03-10 /pmc/articles/PMC5859667/ /pubmed/29523775 http://dx.doi.org/10.12659/AJCR.907440 Text en © Am J Case Rep, 2018 This work is licensed under Creative Common Attribution-NonCommercial-NoDerivatives 4.0 International (CC BY-NC-ND 4.0 (https://creativecommons.org/licenses/by-nc-nd/4.0/) )
spellingShingle Articles
Schloss, Michael
Becak, Daniel
Tosto, Sebastian T.
Velayati, Arash
A Case of Levofloxacin-Induced Hepatotoxicity
title A Case of Levofloxacin-Induced Hepatotoxicity
title_full A Case of Levofloxacin-Induced Hepatotoxicity
title_fullStr A Case of Levofloxacin-Induced Hepatotoxicity
title_full_unstemmed A Case of Levofloxacin-Induced Hepatotoxicity
title_short A Case of Levofloxacin-Induced Hepatotoxicity
title_sort case of levofloxacin-induced hepatotoxicity
topic Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5859667/
https://www.ncbi.nlm.nih.gov/pubmed/29523775
http://dx.doi.org/10.12659/AJCR.907440
work_keys_str_mv AT schlossmichael acaseoflevofloxacininducedhepatotoxicity
AT becakdaniel acaseoflevofloxacininducedhepatotoxicity
AT tostosebastiant acaseoflevofloxacininducedhepatotoxicity
AT velayatiarash acaseoflevofloxacininducedhepatotoxicity
AT schlossmichael caseoflevofloxacininducedhepatotoxicity
AT becakdaniel caseoflevofloxacininducedhepatotoxicity
AT tostosebastiant caseoflevofloxacininducedhepatotoxicity
AT velayatiarash caseoflevofloxacininducedhepatotoxicity