Skin rash and rhabdomyolysis induced by levofloxacin
10.3760/cma.j.issn.1008-5734.2019.03.018
- VernacularTitle:左氧氟沙星致皮疹和横纹肌溶解症
- Author:
Ping LI
1
;
Linlang LIANG
;
Xiaodong SHAO
;
Linan REN
Author Information
1. 北部战区总医院内分泌科,沈阳,110016
- Publication Type:Journal Article
- Keywords:
Rhabdomyolysis;
Drug eruptions;
Quinolones;
Creatine kinase;
Levofloxacin
- From:
Adverse Drug Reactions Journal
2019;21(3):235-236
- CountryChina
- Language:Chinese
-
Abstract:
A 78-year-old male patient received intravenous infusion of levofloxacin 0.5 g once daily due to pneumonia.No other drugs were used during the same period.After medication,the patient's cough and expectoration relieved gradually.However,about 1 week after the medication,skin redness and itching on the face,neck and shoulder,abdominal distension,and muscle pain and weakness appeared and worsened progressively.After 12 days of treatment,levofloxacin was discontinued.The symptoms did not improve 1 week after the drug withdrawal and the patient was hospitalized.On admission,physical examination showed grade 4 and 3 respectively for the upper and lower limbs muscle strength;laboratory tests showed the serum creatine kinase (CK) 9 952 U/L,creatine kinase isozyme (CK-MB) 101 U/L,and myoglobin (Mb) 953 μg/L;muscle biopsy and pathological examination showed partial muscle fiber degeneration,muscle bundle rupture,increased number of myonuclei,slight inflammatory cell infiltration among some muscle bundles,and a little local mucin deposition.Allergic rash and rhabdomyolysis were diagnosed,which was considered to be induced by levofloxacin.Symptomatic supportive treatments such as anti-allergy,alkaline urine,diuresis,and fluid infusion were given.One week later,the rash subsided;3 weeks later,the patient had no muscle pain and his muscle strength of upper and lower limbs returned to grade 5 and 4,with CK 423 U/L,CK-MB 15 U/L,and Mb 128 pg/L.Then the patient was discharged from the hospital and did not take any medicine again.One month later,his muscle strength of limbs recovered and the laboratory tests showed CK 143 U/L,CK-MB 12 U/L,and Mb 62 μg/L.
