Essakow Jenna, Jin Lulu, Marupudi Neelima, Wattier Rachel, McQuillen Patrick, Franzon Deborah
Department of Pediatrics (JE, LJ, NM, RW, PM, DF), Benioff Children's Hospital, University of California, San Francisco, San Francisco, CA.
J Pediatr Pharmacol Ther. 2022;27(6):564-568. doi: 10.5863/1551-6776-27.6.564. Epub 2022 Aug 19.
Most reported cases of serotonin syndrome involve either a selective serotonin reuptake inhibitor (SSRI) or monoamine oxidase inhibitors (MAOI) and at least 1 other serotonergic medication or exposure to a single serotonin-augmenting drug. This case report describes serotonin syndrome occurring in association with the concomitant use of the antibiotic linezolid and opioids, specifically methadone, in a pediatric intensive care unit patient. The patient developed hyperpyrexia, muscle rigidity, clonus, and multiorgan dysfunction within 48 hours of receiving linezolid while concurrently on methadone. This drug-drug interaction is a rare cause of serotonin syndrome that has only been described 1 other time in the adult literature. This report raises awareness of this rare but serious and potentially lethal complication of serotonin syndrome associated with concomitant linezolid and opioid use. Timely consideration of the diagnosis in the setting of hyperpyrexia can facilitate prompt initiation of targeted therapies to prevent sequela.
大多数报告的血清素综合征病例涉及选择性血清素再摄取抑制剂（SSRI）或单胺氧化酶抑制剂（MAOI），以及至少1种其他血清素能药物，或接触单一的血清素增强药物。本病例报告描述了一名儿科重症监护病房患者在同时使用抗生素利奈唑胺和阿片类药物（特别是美沙酮）时发生的血清素综合征。该患者在接受利奈唑胺并同时服用美沙酮的48小时内出现高热、肌肉强直、阵挛和多器官功能障碍。这种药物相互作用是血清素综合征的罕见病因，在成人文献中仅另有1次描述。本报告提高了对这种与利奈唑胺和阿片类药物同时使用相关的罕见但严重且可能致命的血清素综合征并发症的认识。在高热情况下及时考虑诊断有助于迅速启动靶向治疗以预防后遗症。
