Severe linezolid-induced lactic acidosis in a child with acute lymphoblastic leukemia: A case report. Issue 12 (December 2020)

• Record Type: Journal Article
• Authors: Smolka, Vratislav; Rohanova, Marie; Ludikova, Barbora; Novak, Zbynek; Zapalka, Martin; Pospisilova, Dagmar; Volejnikova, Jana
• Is Part Of: Journal of infection and chemotherapy. Volume 26:Issue 12(2020:Dec.)
• Page Start: 1316
• Page End: 1318
• Publication Date: 2020-12
• Subjects: Adverse event -- Child -- Lactic acidosis -- Linezolid -- Plasma concentration; Chemotherapy -- Periodicals; Infection -- Periodicals; Communicable diseases -- Chemotherapy -- Periodicals; 615.5805
• DOI: 10.1016/j.jiac.2020.07.018
• Languages: English
• ISSNs: 1341-321X

Abstract

Abstract: Linezolid is an antibiotic increasingly used for treatment of resistant Gram-positive infections, which blocks bacterial proteosythesis through direct inhibition of mitochondrial ribosomes. The most common adverse effects of linezolid include gastrointestinal symtoms, peripheral neuropathy, bone marrow depression and lactic acidosis. Here we present a rare case of a 9-year-old female, a survivor of acute lymphoblastic leukemia (ALL) and a hematopoietic stem cell transplant (HSCT), who developed life-threatening lactic acidosis with vomiting, impaired consciousness and Kussmaul breathing after 51 days of intravenous linezolid administration due to mycobacterial infection. She fully recovered after drug discontinuation and normalization of the plasma levels. We conclude that plasma lactate concentrations should be monitored closely during any linezolid treatment, particularly in patients with hepatic or renal dysfunction.