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Linezolid Toxicity: A Clinical Case Report.
Ângela Ferreira1, Patrícia Sobrosa1, Miguel Costa1
1Internal Medicine, Hospital de Santa Luzia-Unidade Local de Saúde do Alto Minho, Viana do Castelo, PRT.
Cureus
|April 8, 2024
Summary
Linezolid, an important antibiotic, can cause severe side effects like serotonin syndrome and lactic acidosis. This case highlights these risks in an elderly patient, emphasizing the need for careful monitoring during linezolid treatment.
Area of Science:
- Pharmacology
- Infectious Diseases
- Critical Care Medicine
Background:
- Linezolid is a crucial antibiotic for treating resistant infections.
- It carries risks of serious adverse events, including myelosuppression, serotonin syndrome, and lactic acidosis.
- Elderly patients and those on concomitant serotonergic medications may be at higher risk.
Observation:
- An 80-year-old male on venlafaxine developed symptoms after 36 days of linezolid therapy for a vancomycin-resistant Enterococcus faecium infection.
- Clinical presentation included hypertension, poor perfusion, tremor, disorientation, marbled skin, myoclonus, and sinus tachycardia.
- Laboratory findings revealed hyperlacticemia and mild C-reactive protein elevation.
Findings:
- The patient was diagnosed with lactic acidosis and probable serotonin syndrome secondary to linezolid.
- Symptoms significantly improved upon discontinuation of linezolid.
- This suggests a direct causal link between linezolid and the observed toxicities in this patient.
Implications:
- This case underscores the potential for severe toxicity with linezolid, particularly in the elderly and those on interacting medications.
- Vigilant monitoring for signs of serotonin syndrome and lactic acidosis is essential during linezolid therapy.
- Further research into risk stratification and management strategies for linezolid-induced toxicities is warranted.
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