Ofloxacin: a probable cause of toxic epidermal necrolysis.
OBJECTIVE
To report a fatal case of toxic epidermal necrolysis in a man who was treated with oral ofloxacin for epididymitis.


METHODS
A 75-year-old white man received 23.6 grams of ofloxacin over a 51-day period for epididymitis. He experienced a severe skin reaction diagnosed as toxic epidermal necrolysis. The man died from complications related to toxic epidermal necrolysis.


CONCLUSIONS
Toxic epidermal necrolysis is an infrequent, yet often fatal, severe, systemic, cutaneous disease most often the result of an adverse drug reaction. Fluoroquinolones have rarely been implicated in cases of toxic epidermal necrolysis. A MEDLINE search from 1966 to December 2000 revealed no reports of toxic epidermal necrolysis, erythema multiforme, or Stevens-Johnson syndrome due to ofloxacin therapy. However, a large case-control study included three cases of either Stevens-Johnson syndrome or toxic epidermal necrolysis associated with ofloxacin use, but no details of the cases were given. This report rules out other causes of toxic epidermal necrolysis and implicates ofloxacin in what appears to be an atypical presentation of drug-induced toxic epidermal necrolysis.


CONCLUSIONS
There is very little published information regarding ofloxacin-induced toxic epidermal necrolysis. There are a few case reports of other fluoroquinolones that have been associated with toxic epidermal necrolysis. It is hoped that this case report creates awareness that ofloxacin-induced toxic epidermal necrolysis is possible.
Melde
S L
SL
Central Texas Veterans Health Care System, Pharmacy Service, Temple 76504-7493, USA. Stephen.Melde@Med.VA.Gov
D000368:Aged; D000890:Anti-Infective Agents / Q000009:adverse effects* / Q000627:therapeutic use; D004823:Epididymitis / Q000188:drug therapy; D017809:Fatal Outcome; D006801:Humans; D008297:Male; D015242:Ofloxacin / Q000009:adverse effects* / Q000627:therapeutic use; D013262:Stevens-Johnson Syndrome / Q000473:pathology*
D000890:Anti-Infective Agents; D015242:Ofloxacin