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Probable Levofloxacin-associated Secondary Intracranial Hypertension in a Child With Multidrug-resistant Tuberculosis

Louvina E van der Laan1, H Simon Schaaf, Regan Solomons

  • 1From the *Desmond Tutu TB Centre, Department of Pediatrics and Child Health, ‡Department of Pediatrics and Child Health, and §Department of Ophthalmology, Faculty of Medicine and Health Sciences, Stellenbosch University; and †Brooklyn Hospital for Chest Diseases, Cape Town, South Africa.

The Pediatric Infectious Disease Journal
|March 15, 2016
PubMed

Insights

Levofloxacin may cause intracranial hypertension in children with multidrug-resistant tuberculosis. Early ophthalmologic screening is crucial for pediatric patients on prolonged fluoroquinolone treatment.

Area of Science:

  • Pediatric Infectious Diseases
  • Pharmacovigilance
  • Neurology

Background:

  • Multidrug-resistant tuberculosis (MDR-TB) treatment often involves fluoroquinolones.
  • Fluoroquinolones are essential for managing complex TB cases.
  • Prolonged use of these antibiotics is common in MDR-TB patients.

Observation:

  • A 6-year-old girl with pulmonary MDR-TB developed intracranial hypertension.
  • This adverse event was possibly linked to levofloxacin therapy.
  • The patient presented with signs and symptoms suggestive of increased intracranial pressure.

Findings:

  • This case represents the first report of probable levofloxacin-associated intracranial hypertension in a child.
  • The findings suggest a potential risk of secondary intracranial hypertension in pediatric MDR-TB patients undergoing extended fluoroquinolone treatment.
  • Ophthalmologic evaluation is recommended for children exhibiting relevant symptoms.

Implications:

  • Highlights the importance of monitoring for intracranial hypertension in children receiving fluoroquinolones for MDR-TB.
  • Underscores the need for proactive ophthalmologic screening in this vulnerable pediatric population.
  • Informs clinical practice regarding the safe use of levofloxacin in pediatric MDR-TB management.

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