Levofloxacin-induced delirium with psychotic features.
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.
Kiangkitiwan
Boonsong
B
Department of Internal Medicine, Greater Baltimore Medical Center, Baltimore, MD 21204, USA.
Doppalapudi
Avanthi
A
Fonder
Margaret
M
Solberg
Kim
K
Bohner
Brian
B
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
D000900:Anti-Bacterial Agents; D064704:Levofloxacin; D015242:Ofloxacin