Amikacin
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Bilateral sensory-neural hearing loss for higher frequencies: case report An approximately 58-year-old woman developed bilateral sensory-neural hearing loss for higher frequencies during treatment with amikacin for mastitis due to Mycobacterium abscessus. The woman presented at the age of 57 years, with pain, redness, discharge and itching intermittently in both the breasts from past 6 years, and she also had pain that radiated to axilla. It was noted that, she had recurrent breast infections for the previous 6 years, and she was treated for mastitis. However, she had again developed bilateral breast mass, and she underwent surgery for radical duct excision of both the breasts. On presentation (current), she underwent multiple examinations. She was treated with amoxicillin/clavulanic-acid [augmentin] and metronidazole [metrogyl], and she thereafter remained asymptomtic for 4–6 months. However, she relapsed again with multiple discharging sinuses in the left breast along with redness in the right breast. Tuberculosis was suspected based on tissue cytopathology, and she was treated with empirical antituberculars, including rifampicin, pyrazinamide, isoniazid and ethambutol for 2 months, followed by rifampicin and isoniazid for 7 months; however, only a minimal response was observed. Then, based on microbiological investigations, a confirmed diagnosis of mastitis due to Mycobacterium abscessus was made. Therefore, at the age of ~58 years, she started receiving amikacin 500mg injection [route not stated] along with concomitant rifabutin and clarithromycin. Baseline audiometry was noted to be within normal limit. However, she developed bilateral sensory-neural hearing loss for higher frequencies secondary to amikacin [time to reaction onset not stated]. The woman’s amikacin was therefore replaced by levofloxacin (after 1 month of treatment). The breast lesions were noted to have healed at end of 7 months [outcome of the ADR not stated]. Bala K, et al. Recurrent bilateral breast abscess due to Mycobacterium abscessus in an immune-competent woman. BMJ Case Reports 13: No. 10, Oct 2020. Available from: 803518068 URL: http://doi.org/10.1136/bcr-2020-235857
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Reactions 28 Nov 2020 No. 1832
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