title: Levofloxacin-induced delirium with psychotic features.
abstract: OBJECTIVE
  To raise awareness of a rare but serious adverse effect of a commonly used medication.
  
  
  METHODS
  Report of a case.
  
  
  RESULTS
  A previously healthy 42-year-old woman presented with acute-onset delirium with psychotic features as a consequence of levofloxacin therapy. Withdrawal of the medication was associated with return of the patient's normal mental status.
  
  
  CONCLUSIONS
  The new quinolone derivatives (levofloxacin, sparfloxacin, grepafloxacin, trovafloxacin, gatifloxacin and moxifloxacin), also called gyrase inhibitors, are known for their potential to cause central nervous system-related adverse effects, including headache, dizziness and insomnia. Risk factors for neurotoxicity include renal insufficiency, underlying central nervous system (CNS) disease and increased CNS penetration of drug. Acute delirium resulting from levofloxacin therapy is an exceedingly rare complication that has been thought to occur more commonly in elderly patients. Here, we describe levofloxacin-induced delirium with psychotic features in a relatively young, otherwise healthy female.
authors.affiliation: Department of Internal Medicine, Greater Baltimore Medical Center, Baltimore, MD 21204, USA.
authors.forename: Boonsong
authors.initials: B
authors.lastname: Kiangkitiwan
authors.forename: Avanthi
authors.initials: A
authors.lastname: Doppalapudi
authors.forename: Margaret
authors.initials: M
authors.lastname: Fonder
authors.forename: Kim
authors.initials: K
authors.lastname: Solberg
authors.forename: Brian
authors.initials: B
authors.lastname: Bohner
mesh_terms: D000328:Adult; D000367:Age Factors; D000900:Anti-Bacterial Agents / Q000009:adverse effects* / Q000627:therapeutic use; D003693:Delirium / Q000139:chemically induced* / Q000175:diagnosis; D005260:Female; D006304:Health Status; D006801:Humans; D064704:Levofloxacin; D015242:Ofloxacin / Q000009:adverse effects* / Q000627:therapeutic use; D011605:Psychoses, Substance-Induced / Q000175:diagnosis / Q000209:etiology*; D012852:Sinusitis / Q000188:drug therapy; D014717:Vertigo / Q000188:drug therapy
chemical_list: D000900:Anti-Bacterial Agents; D064704:Levofloxacin; D015242:Ofloxacin