Generalized Seizure and Toxic Epidermal Necrolysis following Levofloxacin Exposure

  title={Generalized Seizure and Toxic Epidermal Necrolysis following Levofloxacin Exposure},
  author={Megan Christie and Karen Wong and Robert H. Ting and P Y Tam and Tabo Sikaneta},
  journal={Annals of Pharmacotherapy},
  pages={953 - 955}
OBJECTIVE: To report the case of a ciprofloxacin-allergic patient who developed a generalized tonic—clonic seizure and toxic epidermal necrolysis (TEN) following a single dose of levofloxacin. CASE SUMMARY: An 87-year-old white woman was admitted to the hospital following a transient episode of unresponsiveness that had been accompanied by flailing of her limbs. Approximately 4 hours earlier, she had developed a pruritic rash on her trunk and limbs, and 3 hours before this had taken a first… 
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  • Medicine
    Annals of the Academy of Medicine, Singapore
  • 2010
A 76-year-old Indian lady who had undergone an open anterior resection for sigmoid colon cancer and was subsequently developed an asymptomatic maculopapular rash 11 days later, was presented with levofloxacin-induced Toxic Epidermal Necrolysis Treated with Intravenous Immunoglobulin.
Toxic epidermal necrolysis induced by levofloxacin.
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Clinicians are advised to closely monitor the possibility of seizures in COPD patients who+ are taking both levofloxacin and theophylline to avoid serious adverse effects.
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Physicians and patients should be alert to the potential for FQ-induced severe disabling multisymptom pathology that may persist and progress following FQ use.
Seizure and Toxic Epidermal Necrolysis with Fluoroquinolone; Another Case of TEN with Levofloxacin; Neurotoxicity with Unexpected High Levels of Free Valproic Acid; Acute Clonidine Withdrawal Leads to an Acute Myocardial Infarction; Hepatotoxicity and Hepatorenal Toxicity with SSRIs; Serotonin Toxic
The purpose of this feature is to heighten awareness of specific adverse drug reactions (ADRs), to discuss methods of prevention, and to promote reporting of ADRs to the FDA's medWatch program
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A patient presenting with low back pain and a history of fluoroquinolone toxicity was treated with intravenous antioxidants and amino acids, an elimination diet, and probiotic supplementation and reported improvements in pain and disability following antioxidant amino acid therapy for a total of 6 months.
Seizures associated with levofloxacin: case presentation and literature review
Clinicians are exhorted to pay close attention when initiating levofloxacin therapy in patients taking medications with epileptogenic properties that are CYP1A2 substrates.
Miscellaneous antibacterial drugs


Ciprofloxacin-Induced Toxic Epidermal Necrolysis
Although TEN occurs rarely with ciprofloxacin, extensive postmarketing surveillance needs to be performed to determine other risk factors for its development and to establish the incidence of TEN and other severe cutaneous reactions caused by cipronilone or the other fluoroquinolones.
Levofloxacin‐Induced Toxic Epidermal Necrolysis in an Elderly Patient
A 78‐year‐old woman with many medical problems, including chronic obstructive pulmonary disease, was treated with parenteral levofloxacin for community‐acquired pneumonia and developed a rash with blistering that progressed to TEN in 7 days.
Ciprofloxacin-induced toxic epidermal necrolysis: a case report.
A well-documented fatal case of ciprofloxacin-induced toxic epidermal necrolysis in a 50-year-old man treated for a bacterial infection of lower extremity venous stasis ulcers is reported.
Fluoroquinolone toxicity profiles: a review focusing on newer agents.
  • Benjamin A Lipsky, C. Baker
  • Biology, Medicine
    Clinical infectious diseases : an official publication of the Infectious Diseases Society of America
  • 1999
Fluoroquinolones are safe in elderly, human immunodeficiency virus-infected, and neutropenic patients, but because of possible effects on articular cartilage, they are not currently recommended for children or pregnant women.
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The side-effect profile of levofloxacin was compared with that of other fluoroquinolones based on European and international data from approximately 130 million prescriptions. Levofloxacin was found
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Although there is sufficient evidence that psychotropic drugs may lower seizure threshold, published literature data have also suggested that an appropriate psychotropic therapy may not only improve the mental state in patients with epilepsy, but also exert antiepileptic effects through a specific action.
Determination of the Excitatory Potencies of Fluoroquinolones in the Central Nervous System by an In Vitro Model
The proposed hippocampus slice model not only is suitable for giving valuable alerts as to convulsive potential during candidate selection but also enables mechanistic investigations, which pointed to the N-methyl-d-aspartate receptor as the probable target of the fluoroquinolone effects.
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There is strong evidence that dysregulation of Fas expression and/or signaling contributes to the pathogenesis of toxic epidermal necrolysis, acute cutaneous graft versus host disease, contact hypersensitivity and melanoma metastasis, and strategies for modulating the function of death receptor signaling pathways have emerged and provided novel therapeutic possibilities.