Fatal acute hepatitis after sequential treatment with levofloxacin, doxycycline, and naproxen in a patient presenting with acute Mycoplasma pneumoniae infection

Carrascosa, Miguel F; Lucena, M. Isabel; Andrade, Raúl J.; Caviedes, José Ramón S.; Lavín, Antonio Cuadrado; Monés, J; Rivero, Andrea; Serrano, Vicente B.

doi:10.1016/j.clinthera.2009.05.012

Cited by 24 publications

(19 citation statements)

References 15 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…107 Nonetheless, cases of levofloxacin-related liver injury have been reported, including cases of hepatic failure. 108–113 The US prescribing information mentions that severe, and sometimes fatal, hepatotoxicity not associated with hypersensitivity has been reported. 114 …”

Section: Fluoroquinolonesmentioning

confidence: 99%

See 1 more Smart Citation

Hepatic safety of antibiotics used in primary care

Andrade

Tulkens

2011

Journal of Antimicrobial Chemotherapy

170

138

View full text Add to dashboard Cite

Antibiotics used by general practitioners frequently appear in adverse-event reports of drug-induced hepatotoxicity. Most cases are idiosyncratic (the adverse reaction cannot be predicted from the drug's pharmacological profile or from pre-clinical toxicology tests) and occur via an immunological reaction or in response to the presence of hepatotoxic metabolites. With the exception of trovafloxacin and telithromycin (now severely restricted), hepatotoxicity crude incidence remains globally low but variable. Thus, amoxicillin/clavulanate and co-trimoxazole, as well as flucloxacillin, cause hepatotoxic reactions at rates that make them visible in general practice (cases are often isolated, may have a delayed onset, sometimes appear only after cessation of therapy and can produce an array of hepatic lesions that mirror hepatobiliary disease, making causality often difficult to establish). Conversely, hepatotoxic reactions related to macrolides, tetracyclines and fluoroquinolones (in that order, from high to low) are much rarer, and are identifiable only through large-scale studies or worldwide pharmacovigilance reporting. For antibiotics specifically used for tuberculosis, adverse effects range from asymptomatic increases in liver enzymes to acute hepatitis and fulminant hepatic failure. Yet, it is difficult to single out individual drugs, as treatment always entails associations. Patients at risk are mainly those with previous experience of hepatotoxic reaction to antibiotics, the aged or those with impaired hepatic function in the absence of close monitoring, making it important to carefully balance potential risks with expected benefits in primary care. Pharmacogenetic testing using the new genome-wide association studies approach holds promise for better understanding the mechanism(s) underlying hepatotoxicity.

show abstract

Section: Fluoroquinolonesmentioning

confidence: 99%

“…145 A recent fatal case has been described, 113 but after exposure to levofloxacin and in association with naproxen. Rarely, minocycline-associated hepatotoxicity has necessitated liver transplantation or proved fatal.…”

Section: Tetracyclinesmentioning

confidence: 99%

Hepatic safety of antibiotics used in primary care

Andrade

Tulkens

2011

Journal of Antimicrobial Chemotherapy

170

138

View full text Add to dashboard Cite

show abstract

“…Berg et al10 found that Mycoplasma antigens can trigger the induction of anti-mitochondrial antibodies, especially through MpPDC-E2-related antibodies and immune reactivity. Carrascosa et al11 also reported a case of lethal hepatitis associated with hepatotoxic drug treatment in a patient with acute Mp infection.…”

Section: Discussionmentioning

confidence: 98%

Fulminant and Fatal Multiple Organ Failure in a 12-Year-Old Boy WithMycoplasma pneumoniaeInfection

Park

Pai

Kim

et al. 2012

Allergy Asthma Immunol Res

View full text Add to dashboard Cite

Mycoplasma pneumoniae (Mp) is a unique pathogen that causes not only pulmonary but also extrapulmonary manifestations that must be rapidly diagnosed. A 12-year-old boy, with no relevant medical history, presented with fever, severe epigastric pain, and vomiting. Laboratory findings showed fulminant and cholestatic hepatitis, hemolytic anemia, thrombocytopenia, acute kidney injury, disseminated intravascular coagulopathy, acute myocardial infarction, and rhabdomyolysis. His clinical condition rapidly deteriorated during intubation and continuous renal replacement therapy. Despite intensive treatment, he did not recover. We report a case of fulminant and fatal multiple organ failure in a previously healthy boy with Mp infection, describing the possible pathomechanisms of multiple organ failure involved in the disease.

show abstract

“…tocelular por trovaflocaxino, lesión hepatocelular ictérica y anictérica con ofloxacino y norfloxacino, respectivamente, lesión colestásica por ciprofloxacino y ofloxacino, hepatitis granulomatosa por flumequina y hepatitis fulminante por ciprofloxacino 7,10 . Respecto a levofloxacino, tras hacer una revisión en Medline entre 1998 y 2010, se han encontrado 7 casos de hepatotoxicidad: cuatro casos atribuibles a levofloxacino 7,10-12 , y tres tras tratamiento secuencial asociado con diferentes antibióticos [13][14][15] . El tipo de daño hepático en casi todos los casos fue de tipo hepatocelular 7,10-12,14,15 , excepto en uno que fue mixto 13 , a diferencia de nuestro caso, que es el primero de tipo colestásico.…”

Section: Sr Directorunclassified