Reactions 1704, p228 - 2 Jun 2018
Various toxicities: case report
A 52-year-old woman developed linezolid induced
mitochondrial toxicity manifesting as abdominal pain, altered
mental status, asthenia, hypotension, tachycardia, acute
pancreatitis, hypoglycaemia and lactic acidosis during
treatment with linezolid [route and dosage not stated].
The woman, who had recurrent diverticulitis complicated by
abscess formation and multiple perforations along with
multiple IR drainages, exploratory laparotomy, and s/p
ileostomy with small bowel resection was discharged on
linezolid and ertapenem. However, on 56 day of linezolid
therapy, she developed asthenia, altered mental status and
acute on chronic abdominal pain. She was hypoglycaemic,
hypotensive and tachycardic. Initially, septic shock due to
intra-abdominal abscess was assumed and she was
hospitalised. Considering the radiographic evidence of peri-
pancreatic fat stranding, she was treated for acute pancreatitis.
She received fluids, piperacillin/tazobactam, vancomycin
along with norepinephrine bitartrate, and was urgently
dialysed. Clinical investigations revealed marked and
persistent lactic acidosis. Considering the other investigations,
infectious etiology was ruled out. A diagnosis of linezolid
induced mitochondrial toxicity was made.
The woman’s antibiotics were discontinued. Subsequently,
her laboratory parameters normalised.She was then
transferred back for further rehabilitation.
Author comment: "Here we present a case of linezolid
toxicity in a patient undergoing sub-acute rehab post
Servillas E, et al. Linezolid toxicity mimics septic shock in a subacute rehab
patient. Journal of the American Geriatrics Society 66 (Suppl. 2): S26, Apr 2018.
Available from: URL: http://doi.org/10.1111/jgs.15376 [abstract] -
Reactions 2 Jun 2018 No. 17040114-9954/18/1704-0001/$14.95 Adis © 2018 Springer International Publishing AG. All rights reserved