Generic placeholder image

Current Drug Safety


ISSN (Print): 1574-8863
ISSN (Online): 2212-3911

Case Report

Linezolid Induced Skin Reactions in a Multi Drug Resistant Infective Endocarditis Patient: A Rare Case

Author(s): Asha K. Rajan, Ananth Kashyap, Manik Chhabra and Muhammed Rashid*

Volume 15, Issue 3, 2020

Page: [222 - 226] Pages: 5

DOI: 10.2174/1574886315666200516175053

Price: $65


Rationale: Linezolid (LNZ) induced Cutaneous Adverse Drug Reactions (CADRs) have rare atypical presentation. Till date, there are very few published case reports on LNZ induced CADRs among the multidrug-resistant patients suffering from Infective Endocarditis (MDR IE). Here, we present a rare case report of LNZ induced CARs in a MDR IE patient.

Case Report: A 24-year-old female patient was admitted to the hospital with chief complaints of fever (101°C) associated with rigors, chills, and shortness of breath (grade IV) for the past 4 days. She was diagnosed with MDR IE, having a prior history of rheumatic heart disease. She was prescribed LNZ 600mg IV BD for MDR IE, against Staphylococcus coagulase-negative. The patient experienced flares of cutaneous reactions with multiple hyper-pigmented maculopapular lesions all over the body after one week of LNZ therapy. Upon causality assessment, she was found to be suffering from LNZ induced CADRs. LNZ dose was tapered gradually and discontinued. The patient was prescribed corticosteroids along with other supportive care. Her reactions completely subsided and infection got controlled following 1 month of therapy.

Conclusion: Healthcare professionals should be vigilant for rare CADRs, while monitoring the patients on LNZ therapy especially in MDR patients as they are exposed to multiple drugs. Moreover, strengthened spontaneous reporting is required for better quantification.

Keywords: Infective endocarditis, linezolid, multidrug-resistant, adverse drug reaction, MDR patients, LNZ therapy.

Graphical Abstract
Radhakrishnan BK, Sreekantan R, Panicker VT, Karunakaran J. Outcomes of mitral valve replacement after closed mitral valvotomy: a retrospective cohort study. Heart Surg Forum 2019; 22(3): E207-12.
[] [PMID: 31237544]
Habib G, Lancellotti P, Erba PA, et al. EURO-ENDO Investigators. The ESC-EORP EURO-ENDO (European infective endocarditis) registry. Eur Heart J Qual Care Clin Outcomes 2019; 5(3): 202-7.
[] [PMID: 30957862]
Wunderlich NC, Dalvi B, Ho SY, Küx H, Siegel RJ. Rheumatic mitral valve stenosis: diagnosis and treatment options. Curr Cardiol Rep 2019; 21(3): 14.
[] [PMID: 30815750]
Bhatt P, Tandel K, Singh A, Mugunthan M, Grover N, Sahni AK. Species distribution and antimicrobial resistance pattern of Coagulase-negative Staphylococci at a tertiary care centre. Med J Armed Forces India 2016; 72(1): 71-4.
[] [PMID: 26900227]
San-Juan R, Martínez-Redondo I, Fernández-Ruiz M, et al. A short course of antibiotic treatment is safe after catheter withdrawal in catheter-related bloodstream infections due to coagulase-negative staphylococci. Eur J Clin Microbiol Infect Dis 2019; 38(5): 977-83.
[] [PMID: 30924012]
Plicht B, Lind A, Erbel R. Infective endocarditis: new ESC guidelines 2016; 57(7): 675-90.
Trifunovic D, Vujisic-Tesic B, Obrenovic-Kircanski B, et al. The relationship between causative microorganisms and cardiac lesions caused by infective endocarditis: New perspectives from the contemporary cohort of patients. J Cardiol 2018; 71(3): 291-8.
[] [PMID: 29055511]
Keller K, Hobohm L, Munzel T, Ostad MA. Incidence of infective endocarditis before and after the guideline modification regarding a more restrictive use of prophylactic antibiotics therapy in the USA and Europe. Minerva Cardioangiol 2019; 67(3): 200-6.
[] [PMID: 30724268]
Chaves F, Garnacho-Montero J, Del Pozo JL, et al. Diagnosis and treatment of catheter-related bloodstream infection: clinical guidelines of the Spanish society of infectious diseases and clinical microbiology and (SEIMC) the Spanish society of intensive and critical care medicine and coronary units (SEMICYUC). Med Intensiva 2018; 42(1): 5-36.
[] [PMID: 29406956]
Amiyangoda CGK, Wimalaratna H, Bowatte S. A complicated prosthetic valve endocarditis due to methicillin resistant staphylococci treated with linezolid and ciprofloxacin: a case report. BMC Res Notes 2017; 10(1): 580.
[] [PMID: 29121980]
Camou F, Dijos M, Barandon L, et al. Management of infective endocarditis and multidisciplinary approach. Med Mal Infect 2019; 49(1): 17-22.
[] [PMID: 30029968]
Holland TL, Arnold C, Fowler VG Jr. Clinical management of Staphylococcus aureus bacteremia: a review. JAMA 2014; 312(13): 1330-41.
[] [PMID: 25268440]
Kishor K, Dhasmana N, Kamble SS, Sahu RK. Linezolid induced adverse drug reactions: an update. Curr Drug Metab 2015; 16(7): 553-9.
[] [PMID: 26424176]
Nayak S, Nandwani A, Rastogi A, Gupta V. Acute interstitial nephritis and drug rash with secondary to Linezolid. Indian J Nephrol 2012; 22(5): 367-9.
[] [PMID: 23326048]
Gandra S, Tseng KK, Arora A, et al. The mortality burden of multidrug-resistant pathogens in India: a retrospective, observational study. Clin Infect Dis 2019; 69(4): 563-70.
[] [PMID: 30407501]
Zambernardi A, Label M. Cutaneous adverse drug reactions: how to identify the trigger. Actas Dermosifiliogr 2018; 109(8): 699-707.
[] [PMID: 29996988]
Polak D, Hafner C, Briza P, Kitzmuller C, Elbe-Burger A, Samadi N, et al. A novel role for neutrophils in Ig E-mediated allergy: Evidence for antigen presentation in late phase reactions. J Allergy Clin Immunol 2019; 143(3): 1143-52. e4.
Krause W. Drug-induced hperpigemntation: a systematic review. J Dtsch Dermatol Ges 2013; 11(7): 644-51.
[PMID: 23650908]
Halaban R, Hebert D, Fisher D. Biology of MelanocytesFitzpatrick’s Dermatology in General Medicine. 6th ed. New York: McGraw-Hill 2003; pp. 127-48.
Rashid M, Kashyap A, Undela K. Valproic acid and Stevens-Johnson syndrome: a systematic review of descriptive studies. Int J Dermatol 2019; 58(9): 1014-22.
[] [PMID: 30809807]
Rashid M, Rajan AK, Chhabra M, Kashyap A. Levetiracetam and cutaneous adverse reactions: A systematic review of descriptive studies. Seizure 2020; 75: 101-9.
[] [PMID: 31931437]
Gill GK, Chhabra M, Chawla SPS. Levofloxacin-induced desquamation: a possible and rare case report. Curr Drug Saf 2020; 15(1): 61-4.
[] [PMID: 31284870]
Jangra MS, Chhabra M. Cycloserine induced suicidal tendencies and kanamycin induced ototoxicity in Indian MDR-TB patient: a case report. Curr Drug Saf 2018; 13(3): 211-3.
[] [PMID: 29866015]
Sharma A, Sharma P, Gaur A, Chhabra M, Kaur R. A cross-sectional study on diabetes mellitus Type-2 at a tertiary care hospital. Adv Res Gastroentero Hepatol 2017; 8(1): 1-6.

Rights & Permissions Print Export Cite as
© 2023 Bentham Science Publishers | Privacy Policy