One suspected case of toxic epidermal necrolysis induced by levofloxacin

XU Li-jun; LI Xing-xia

Abstract：One 79-year-old male patient was hospitalized because of edema of both lower extremities, cough and expectoration for more than 1 month, aggravation with hepatic dysfunction for 4 days. The patient described a history of cerebral hemorrhage and liver dysfunction for several years, but denied the history of drugs and food allergies. Hepatoprotective, diuretic and other supportive treatments were given for 1 day after admission, edema of both lower extremities relieved, meanwhile the symptoms of cough and expectoration aggravated accompanying with fever. Levolfoxacin (0.5 g, qd, ivgtt) combined with cefoperazone and sulbactam sodium (3 g, bid, ivgtt) were prescribed against infection. After 3 days, several blisters appeared in the patient's lips and erythema scattered all over his face, then levolfoxacin was stopped immediately. After that the erythema spread to four limbs and the mucosa developed into erosion and peeling, which was diagnosed as toxic epidermal necrolysis by dermatologist two days later. The symptomatic treatments were given in respect of methylprednisolone and other antiallergic remedy, correcting the electrolyte imbalance and strengthening the nursing of damaged skin. Since then, no new rash appeared, and skin wound dried and healed gradually.