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[Skin pigmentation induced by meropenem and levofloxacin]
E Garval1, V Vuiblet2, A Durlach3
1Service de dermatologie, hôpital Robert-Debré, CHU de Reims, avenue du Général-Kœnig, 51092 Reims cedex, France.
Annales De Dermatologie Et De Venereologie
|October 17, 2017
Summary
This case study reports cutaneous hyperpigmentation in a patient treated with meropenem and levofloxacin antibiotics. Infrared spectroscopy identified meropenem in the dermis, suggesting it as a cause of the skin discoloration.
Area of Science:
- Dermatology
- Pharmacology
- Infectious Diseases
Background:
- Cutaneous side-effects are known for antibiotics like meropenem (carbapenem) and levofloxacin (fluoroquinolone).
- Reported side-effects include exanthema, pruritus, urticaria, and severe conditions like Lyell or Stevens-Johnson syndrome.
- Levofloxacin also carries a risk of photosensitivity.
Observation:
- A 67-year-old male developed dark hyperpigmentation on his lower limbs after two weeks of antibiotic therapy for osteitis.
- The patient was treated with meropenem, levofloxacin, and amikacin, followed by meropenem, levofloxacin, and rifampicin.
- Histology showed dark deposits in the dermis, and infrared microspectroscopy identified meropenem within the skin.
Findings:
- This is the first reported case of cutaneous hyperpigmentation induced by meropenem.
- Infrared spectroscopy confirmed the presence of meropenem in the dermis of the affected skin.
- The pigmentation slowly subsided after the withdrawal of the antibiotics.
Implications:
- This case highlights a rare but identifiable side-effect of meropenem and levofloxacin combination therapy.
- Understanding the causative agent through techniques like infrared spectroscopy is crucial for diagnosis and management.
- Further research may elucidate the exact mechanism of pigment deposition in the dermis.