Ghoshal Arunangshu, Damani Anuja, Salins Naveen, Deodhar Jayita, Muckaden Mary Ann
Department of Palliative Medicine, Tata Memorial Centre, Mumbai, Maharashtra, India.
Indian J Palliat Care. 2015 Jan-Apr;21(1):76-8. doi: 10.4103/0973-1075.150194.
Levofloxacin is a commonly prescribed antibiotic for managing chest and urinary tract infections in a palliative care setting. Incidence of Levofloxacin-associated anaphylaxis is rare and delirium secondary to Levofloxacin is a seldom occurrence with only few published case reports. It is an extremely rare occurrence to see this phenomenon in combination. Early identification and prompt intervention reduces both mortality and morbidity. A 17-year-old male with synovial sarcoma of right thigh with chest wall and lung metastasis and with no prior psychiatric morbidity presented to palliative medicine outpatient department with community-acquired pneumonia. He was initiated on intravenous (IV) Ceftriaxone and IV Levofloxacin. Post IV Levofloxacin patient developed anaphylaxis and acute delirium necessitating IV Hydrocortisone, IV Chlorpheneramine, Oxygen and IV Haloperidol. Early detection and prompt intervention helped in complete recovery. Patient was discharged to hospice for respite after 2 days of hospitalization and then discharged home. Acute palliative care approach facilitated management of two life-threatening medical complications in a palliative care setting improving both quality and length of life.
左氧氟沙星是姑息治疗中常用于治疗胸部和尿路感染的抗生素。左氧氟沙星相关过敏反应的发生率很低，继发于左氧氟沙星的谵妄很少见，仅有少数已发表的病例报告。同时出现这种现象极为罕见。早期识别和及时干预可降低死亡率和发病率。一名17岁男性，右大腿滑膜肉瘤伴胸壁和肺转移，既往无精神疾病史，因社区获得性肺炎就诊于姑息医学门诊。他开始接受静脉注射头孢曲松和静脉注射左氧氟沙星治疗。静脉注射左氧氟沙星后，患者出现过敏反应和急性谵妄，需要静脉注射氢化可的松、静脉注射氯苯那敏、吸氧和静脉注射氟哌啶醇。早期发现和及时干预有助于完全康复。患者住院2天后出院至临终关怀机构暂歇，随后出院回家。急性姑息治疗方法有助于在姑息治疗环境中处理两种危及生命的医疗并发症，改善了生活质量和寿命。
