Linezolid
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Rhabdomyolysis and lactic acidosis: case report A 24-year-old woman developed rhabdomyolysis and lactic acidosis during treatment with linezolid for methicillin-resistant Staphylococcus aureus (MRSA) pneumonia. The woman, who had a history of adult-onset Leigh syndrome, was admitted to the ICU for supportive care of medical complications following a surgery of thyroid cancer. Subsequently, she developed a progressive syndrome characterised by bilateral ptosis, cerebellar ataxia, external ophthalmoplegia, exercise intolerance and severe deafness. On ICU admission, her serum lactate was normal and creatine kinase was mildly elevated at 254 IU/L. She started receiving linezolid 600mg twice daily for MRSA pneumonia [route not stated]. After two doses of linezolid, she developed nausea, vomiting, tachypnoea, tachycardia and very severe muscle pain followed by severe muscle weakness causing flaccid quadriplegia. Laboratory investigations revealed elevated serum lactate, creatinine kinase and creatinine with glomerular filtration rate of 9.8 mL/min. On the basis of these findings, she was diagnosed with linezolid-induced rhabdomyolysis and lactic acidosis complicated by renal function impairment. The woman’s linezolid was therefore discontinued, and dialysis was initiated. Her lactate level normalised within 5 days and creatinine kinase returned to pre-treatment level within 7 days. At the same time, her kidney function improved requiring no dialysis. Within 10 days after linezolid discontinuation, her muscle involvement significantly improved. Primiano G, et al. A severe linezolid-induced rhabdomyolysis and lactic acidosis in Leigh syndrome. Journal of Inherited Metabolic Disease : 5 Nov 2020. Available from: 803519527 URL: http://doi.org/10.1002/jimd.12328
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Reactions 5 Dec 2020 No. 1833
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