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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...
Autores principales: | , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
International Scientific Literature, Inc.
2018
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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 |
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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 |
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