Levofloxacin-associated transient mixed sensorimotor lacunar syndrome

BMJ Case Rep. 2022 Dec 22;15(12):e252052. doi: 10.1136/bcr-2022-252052.

Abstract

Fluoroquinolones are commonly used antimicrobials with multiple known adverse effects, yet overdose events are rarely reported. Here, we report a case of a previously healthy middle-aged woman who unintentionally ingested 7 g of levofloxacin in one dose. Thereafter, she presented to the emergency department with hemiparesis concerning for ischaemic stroke and was administered tissue plasminogen activator. Her brain imaging showed no ischaemic injury and her symptoms resolved within 24 hours; this is consistent with a transient ischaemic attack. Our case highlights potential adverse effects of an acute overdose of levofloxacin that has not previously been well described.

Keywords: Drugs: infectious diseases; Stroke; Unwanted effects / adverse reactions.

Publication types

  • Case Reports

MeSH terms

  • Brain Ischemia* / chemically induced
  • Drug Overdose*
  • Drug-Related Side Effects and Adverse Reactions*
  • Female
  • Humans
  • Levofloxacin / adverse effects
  • Middle Aged
  • Stroke* / drug therapy
  • Stroke, Lacunar*
  • Tissue Plasminogen Activator / therapeutic use

Substances

  • Tissue Plasminogen Activator
  • Levofloxacin