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左氧氟沙星诱发的伴有精神病性症状的谵妄。

Levofloxacin-induced delirium with psychotic features.

作者信息

Kiangkitiwan Boonsong, Doppalapudi Avanthi, Fonder Margaret, Solberg Kim, Bohner Brian

机构信息

Department of Internal Medicine, Greater Baltimore Medical Center, Baltimore, MD 21204, USA.

出版信息

Gen Hosp Psychiatry. 2008 Jul-Aug;30(4):381-3. doi: 10.1016/j.genhosppsych.2007.11.003.

Abstract

OBJECTIVE

To raise awareness of a rare but serious adverse effect of a commonly used medication.

METHOD

Report of a case.

RESULTS

A previously healthy 42-year-old woman presented with acute-onset delirium with psychotic features as a consequence of levofloxacin therapy. Withdrawal of the medication was associated with return of the patient's normal mental status.

CONCLUSION

The new quinolone derivatives (levofloxacin, sparfloxacin, grepafloxacin, trovafloxacin, gatifloxacin and moxifloxacin), also called gyrase inhibitors, are known for their potential to cause central nervous system-related adverse effects, including headache, dizziness and insomnia. Risk factors for neurotoxicity include renal insufficiency, underlying central nervous system (CNS) disease and increased CNS penetration of drug. Acute delirium resulting from levofloxacin therapy is an exceedingly rare complication that has been thought to occur more commonly in elderly patients. Here, we describe levofloxacin-induced delirium with psychotic features in a relatively young, otherwise healthy female.

摘要

目的

提高对一种常用药物罕见但严重不良反应的认识。

方法

病例报告。

结果

一名既往健康的42岁女性因左氧氟沙星治疗出现急性起病的谵妄并伴有精神病性症状。停用该药物后患者恢复正常精神状态。

结论

新型喹诺酮衍生物(左氧氟沙星、司帕沙星、格帕沙星、曲伐沙星、加替沙星和莫西沙星),也称为回旋酶抑制剂,因其有可能引起中枢神经系统相关不良反应而闻名,包括头痛、头晕和失眠。神经毒性的危险因素包括肾功能不全、潜在的中枢神经系统(CNS)疾病以及药物在中枢神经系统的渗透率增加。左氧氟沙星治疗导致的急性谵妄是一种极其罕见的并发症,以往认为在老年患者中更常见。在此,我们描述了一名相对年轻、其他方面健康的女性出现具有精神病性特征的左氧氟沙星所致谵妄。

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