Levofloxacin Induced Stomatitis: A Case Report

Abstract

Introduction: fluoroquinolones have many adverse effects include the gastrointestinal tract and the central nervous system, phototoxicity, and dermal toxicity. Levofloxacin has favorable adverse reaction profiles compared to other fluoroquinolones. Among the reported dermal toxicity, there are few reports of TEN in association with levofloxacin usage. However, there is no published study on levofloxacin induced stomatitis. Stomatitis is characterized by pain, inflammation, and ulceration in the oral cavity. It can affect patient ability to eat, talk or daily workout. Hence, caution is advised while administering drugs with this potential adverse effect. Case Presentation: A 36-year-old man was referred to the hospital for ‘painful oral swelling and ulceration’. Before the admission due to a fever and productive cough, 750 mg levofloxacin were prescribed for him. After 2 days of consumption, the patient experiences painful ulcerative and erythema lesions in the oral cavity that consistent with stomatitis. Upon hospitalization, the patient only had 38 degrees and all laboratory value was in normal ranges except ESR, that was 89. Due to the possibility of a drug reaction, levofloxacin was discontinued and no other antibiotic was used. Oral lesions were managed with mouthwash and after 5 to 7 days, lesions recovered. Conclusions: To the best of our knowledge, this is the first case of a patient who developed stomatitis adverse drug reaction after two doses of levofloxacin and recovered just with topical therapy and without any systemic treatment. Further fluoroquinolone use should be avoided in such patients.

Keywords

• fluoroquinolones
• levofloxacin
• stomatitis
• oral mucositis