A Case of Levo fl oxacin-Induced Hepatotoxicity #MMPMID29523775
Schloss M; Becak D; Tosto ST; Velayati A
Am J Case Rep 2018[Mar]; 19 (ä): 272-276 PMID29523775show ga
BACKGROUND Levo fl oxacin covers a broad spectrum of pathogens and is readily prescribed by clinicians. Hepatotoxicity is a known but unusual complication of levo fl oxacin 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 levo fl oxacin administration showed aminotransferase levels raised to approximately 50 times baseline within a few days. Levo fl oxacin 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 levo fl oxacin can induce hepatotoxicity in rare cases. In patients presenting with acute liver injury who have recently taken levo fl oxacin, it would be wise to remain cognizant of the possibility of levo fl oxacin-induced hepatotoxicity.
|Anti-Bacterial Agents/adverse effects[MESH]
|Chemical and Drug Induced Liver Injury/*etiology[MESH]
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Am+J+Case+Rep 2018 ; 19 (ä): 272-276
