Early onset probable linezolid-induced encephalopathy.
Linezolid is increasingly being utilized for the treatment of gram-positive pathogens. While neurological complications with linezolid are rare, long-term exposure can be associated with neurotoxic effects. Patients with pre-existing neurologic sequelae or risk factors, such as alcohol abuse, diabetes, or concomitant administration of chemotherapeutic agents and/or antiretroviral therapy, may be more susceptible to the development of linezolid-induced neurotoxicity. We describe a 41-year-old male who developed early onset encephalopathy after a day and a half of linezolid therapy. Our patient had at least one significant risk factor (alcoholism), making linezolid-induced encephalopathy probable based upon the Naranjo probability scale. Clinicians should be aware of the potential for early onset linezolid-induced neurotoxicity, particularly in patients with concomitant risk factors.
Fletcher
Jeffery
J
Department of Neurology (Neurocritical Care), Bronson Methodist Hospital, 601 John Street Suite M-124, Kalamazoo, MI 49007, USA. jeffletc@med.umich.edu
Aykroyd
Laura E
LE
Feucht
Eric C
EC
Curtis
James M
JM
D000081:Acetamides / Q000009:adverse effects*; D000328:Adult; D020268:Alcohol-Induced Disorders, Nervous System / Q000150:complications*; D000437:Alcoholism / Q000150:complications*; D000890:Anti-Infective Agents / Q000009:adverse effects; D001921:Brain / Q000187:drug effects* / Q000473:pathology / Q000503:physiopathology; D015984:Causality; D006333:Heart Failure / Q000139:chemically induced / Q000150:complications; D006801:Humans; D000069349:Linezolid; D008103:Liver Cirrhosis / Q000139:chemically induced / Q000150:complications; D008297:Male; D020258:Neurotoxicity Syndromes / Q000473:pathology / Q000503:physiopathology* / Q000517:prevention & control; D023303:Oxazolidinones / Q000009:adverse effects*; D018579:Patient Selection; D011023:Pneumonia, Staphylococcal / Q000188:drug therapy*; D012307:Risk Factors
D000081:Acetamides; D000890:Anti-Infective Agents; D023303:Oxazolidinones; D000069349:Linezolid