Severe linezolid-induced lactic acidosis in a child with acute lymphoblastic leukemia: A case report |
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| Affiliation: | 1. Chemistry and Metabolic Disease Laboratory, Children''s Medical Center Dallas, USA;2. Department of Pathology, UT Southwestern Medical Center, USA;3. Biochemical Genetics Laboratory, Children''s Hospital of Eastern Ontario, Canada;4. Department of Pathology and Laboratory Medicine, University of Ottawa, Canada;1. Department of Pharmacy, The Johns Hopkins Hospital, Baltimore, MD, USA;2. Department of Pediatrics, Division of Pediatric Infectious Diseases, Johns Hopkins University School of Medicine, Baltimore, MD, USA;3. University of Maryland School of Pharmacy, Baltimore, MD, USA;4. Johns Hopkins Bloomberg School of Public Health, Department of Epidemiology, Baltimore, MD, USA;5. Department of Medicine, Division of Infectious Diseases, Johns Hopkins University School of Medicine, Baltimore, MD, USA |
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| Abstract: | Linezolid is an antibiotic increasingly used for treatment of resistant Gram-positive infections, which blocks bacterial proteosythesis through direct inhibition of mitochondrial ribosomes. The most common adverse effects of linezolid include gastrointestinal symtoms, peripheral neuropathy, bone marrow depression and lactic acidosis.Here we present a rare case of a 9-year-old female, a survivor of acute lymphoblastic leukemia (ALL) and a hematopoietic stem cell transplant (HSCT), who developed life-threatening lactic acidosis with vomiting, impaired consciousness and Kussmaul breathing after 51 days of intravenous linezolid administration due to mycobacterial infection. She fully recovered after drug discontinuation and normalization of the plasma levels.We conclude that plasma lactate concentrations should be monitored closely during any linezolid treatment, particularly in patients with hepatic or renal dysfunction. |
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| Keywords: | Adverse event Child Lactic acidosis Linezolid Plasma concentration |
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