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Linezolid-Induced Pancreatitis Associated with Lactic Acidosis and Relative Hypoglycemia: A Rare Case Report
Gi Eun Kim1, Soubiya Mohammed Rizwan Ansari1, Ateeque Mohamed Ali2
1Department of Internal Medicine, Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar.
Background:
Linezolid is known to cause side effects, including nausea, diarrhea, and headaches of short duration. As extended use of linezolid is becoming more common, additional rare side effects should be considered.
Case Presentation:
A 68-year-old man hospitalized for osteomyelitis developed severe abdominal pain and altered mental status following five weeks of linezolid therapy. Laboratory studies showed very high lipase levels, lactic acidosis not responding to resuscitation, and relative hypoglycemia. All common causes of pancreatitis were ruled out, and a trial of linezolid withdrawal was done resulting in drastic improvement in the patient's clinical status.
Conclusions:
For patients on extended course of linezolid who develop abdominal pain, drug-induced pancreatitis should be considered as a side effect, and a trial of withdrawal of linezolid should be undertaken.
Learning Points:
Linezolid can be associated with a rare but serious triad of adverse effects of pancreatitis, hypoglycemia, and lactic acidosis.Possible risk factors include a prolonged course of linezolid, renal dysfunction, and sepsis.
Insights
Extended linezolid use may cause rare but serious side effects like pancreatitis, hypoglycemia, and lactic acidosis. Clinicians should consider drug-induced pancreatitis in patients with abdominal pain during linezolid therapy.
Area of Science:
- Infectious Diseases
- Pharmacology
- Critical Care Medicine
Background:
- Linezolid is an antibiotic commonly used for serious infections.
- Extended linezolid use is increasing, necessitating awareness of potential rare adverse events.
- Known side effects include nausea, diarrhea, and headaches.
Purpose of the Study:
- To highlight a rare but severe adverse effect of linezolid therapy.
- To emphasize the importance of considering drug-induced pancreatitis in patients on extended linezolid treatment.
Main Methods:
- A case presentation of a 68-year-old male patient with osteomyelitis treated with linezolid.
- Clinical and laboratory findings during linezolid therapy were analyzed.
- The patient's response to linezolid withdrawal was observed.
Main Results:
- The patient developed severe abdominal pain, altered mental status, lactic acidosis, and hypoglycemia after five weeks of linezolid.
- Pancreatitis was diagnosed, and other common causes were excluded.
- Discontinuation of linezolid led to significant clinical improvement.
Conclusions:
- Linezolid can be associated with a rare triad of pancreatitis, hypoglycemia, and lactic acidosis.
- Drug-induced pancreatitis should be considered in patients on extended linezolid therapy presenting with abdominal pain.
- Risk factors may include prolonged treatment duration, renal dysfunction, and sepsis.
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