Levofloxacin
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First report of myasthenic crisis: case report A 45-year-old man began receiving levofloxacin [dosage not stated] for atypical pneumonia. After 36 hours, he presented to an emergency department with severe respiratory difficulty. He was mechanically ventilated and intubated, and was diagnosed with severe respiratory insufficiency. He had a positive result on the tensilon test, and an electromyogram revealed a decremental response. He was diagnosed with myasthenia gravis. A CT scan revealed thymoma, and he underwent thymectomy. He began receiving pyridostigmine and corticosteroid treatment. On day 3, he was removed from the ventilator. On day 10, he was discharged in a healthy condition. Author comment: "This case shows that, like other quinolones, levofloxacin may also have a symptom triggering effect in subclinical [myasthenia gravis] and may even lead to myasthenic crises." Gunduz A, et al. Levofloxacin induced myasthenia crisis. Emergency Medicine 801044500 Journal 23: 662, No. 8, Aug 2006 - Turkey
» Editorial comment: A search of AdisBase and Medline did not reveal any previous case reports of myasthenic crisis associated with levofloxacin. The WHO Adverse Drug Reactions database contained eight reports of myasthenia gravis-like syndrome associated with levofloxacin.
0114-9954/10/1121-0001/$14.95 Adis © 2010 Springer International Publishing AG. All rights reserved
Reactions 30 Sep 2006 No. 1121
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