Abstract
Cushing's syndrome (CS) is common after oral steroid use and has also been reported following topical or inhaled use, but it is extremely uncommon after intranasal administration. In this paper, we present the case of a child who developed CS after intranasal application of combined moxifloxacin-dexamethasone eye drops for epistaxis for a period of 3 months. CS caused by ocular preparations of steroids has not been reported previously. This case report highlights the fact that even eye drops can contain high doses of steroids and can lead to CS especially in children and especially if used intranasally. Ocular steroid drops should not be used intranasally. To minimize gastrointestinal absorption and therefore the risk of CS, nasal sprays should be preferred over nasal drops for intranasal steroid application.
MeSH terms
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Administration, Intranasal
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Anti-Infective Agents / administration & dosage
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Anti-Infective Agents / adverse effects
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Anti-Infective Agents / therapeutic use
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Aza Compounds / administration & dosage
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Aza Compounds / adverse effects
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Aza Compounds / therapeutic use
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Child
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Cushing Syndrome / chemically induced*
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Cushing Syndrome / complications
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Dexamethasone / administration & dosage
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Dexamethasone / adverse effects*
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Dexamethasone / therapeutic use
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Drug Combinations
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Epistaxis / complications
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Epistaxis / drug therapy
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Female
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Fluoroquinolones
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Glucocorticoids / administration & dosage
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Glucocorticoids / adverse effects*
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Glucocorticoids / therapeutic use
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Humans
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Iatrogenic Disease*
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Indien
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Moxifloxacin
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Ophthalmic Solutions / administration & dosage
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Ophthalmic Solutions / adverse effects
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Ophthalmic Solutions / therapeutic use
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Prescription Drug Misuse*
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Quinolines / administration & dosage
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Quinolines / adverse effects
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Quinolines / therapeutic use
Substances
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Anti-Infective Agents
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Aza Compounds
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Drug Combinations
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Fluoroquinolones
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Glucocorticoids
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Ophthalmic Solutions
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Quinolines
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Dexamethasone
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Moxifloxacin