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Ciprofloxacin Exposure Leading to Fatal Hepatotoxicity: An Unusual Correlation

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ABSTRACT

Patient: female, 74"/>

Lab values on the days of admission and discharge, days 1 and 3 respectively, from inpatient stay 1.
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f1-amjcaserep-17-676: Lab values on the days of admission and discharge, days 1 and 3 respectively, from inpatient stay 1.

Mentions: Following increased weakness and near-syncope, she was admitted for hospital evaluation. A thorough history revealed a past medical history of hypertension, hyperlipidemia, gastro-esophageal reflux disease (GERD), and hypothyroidism. Her only medications included simvastatin (Zocor) 20 mg daily, pantoprazole (Protonix) 20 mg daily, and levothyroxine (Synthroid) 75 mcg daily. She denied any history of herbal supplements, acetaminophen use, or previous liver disease. She also denied any tobacco, alcohol, or illicit drug use. Additionally, her physical examination was essentially unremarkable. Significant labs on admission included: aspartate transaminase (AST) 1,106, alanine transaminase (ALT) 789, alkaline phosphatase (ALP) 338, total bilirubin (TBIL) 2.75, albumin 2.6, hemoglobin 11.6, white blood cells 4,700, and platelets 142,000 (Figure 1). She was also found to have a UTI, and was again treated with three days of ciprofloxacin, as the antibiotic had not yet been considered as a likely cause of the patient’s hepatitis. Instead, the patient’s abnormal liver transaminases were incorrectly attributed to dehydration and hypoperfusion, as she reported a history of anorexia and poor fluid intake. Following slight improvement in transaminase values, she was discharged on day 3.


Ciprofloxacin Exposure Leading to Fatal Hepatotoxicity: An Unusual Correlation
Lab values on the days of admission and discharge, days 1 and 3 respectively, from inpatient stay 1.
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC5036381&req=5

f1-amjcaserep-17-676: Lab values on the days of admission and discharge, days 1 and 3 respectively, from inpatient stay 1.
Mentions: Following increased weakness and near-syncope, she was admitted for hospital evaluation. A thorough history revealed a past medical history of hypertension, hyperlipidemia, gastro-esophageal reflux disease (GERD), and hypothyroidism. Her only medications included simvastatin (Zocor) 20 mg daily, pantoprazole (Protonix) 20 mg daily, and levothyroxine (Synthroid) 75 mcg daily. She denied any history of herbal supplements, acetaminophen use, or previous liver disease. She also denied any tobacco, alcohol, or illicit drug use. Additionally, her physical examination was essentially unremarkable. Significant labs on admission included: aspartate transaminase (AST) 1,106, alanine transaminase (ALT) 789, alkaline phosphatase (ALP) 338, total bilirubin (TBIL) 2.75, albumin 2.6, hemoglobin 11.6, white blood cells 4,700, and platelets 142,000 (Figure 1). She was also found to have a UTI, and was again treated with three days of ciprofloxacin, as the antibiotic had not yet been considered as a likely cause of the patient’s hepatitis. Instead, the patient’s abnormal liver transaminases were incorrectly attributed to dehydration and hypoperfusion, as she reported a history of anorexia and poor fluid intake. Following slight improvement in transaminase values, she was discharged on day 3.

View Article: PubMed Central - PubMed

ABSTRACT

Patient: female, 74"/>