Clin Drug Invest 2004; 24 (8): 487-489 CASE REPORT 1173-2563/04/0008-0487/$31.00/0  2004 Adis Data Information BV. All rights reserved. Levofloxacin-Induced Taste Perversion, Blurred Vision and Dyspnoea in a Young Woman Luca Gallelli, 1 Serena Del Negro, 1 Saverio Naty, 2 Manuela Colosimo, 1 Rosario Maselli 2 and Giovambattista De Sarro 1 1 Clinical Pharmacology and Pharmacovigilance Unit, Department of Experimental and Clinical Medicine, Faculty of Medicine and Surgery, University “Magna Graecia” of Catanzaro, Regional Pharmacovigilance Center, “Mater Domini” University Hospital, Catanzaro, Italy 2 Chair of Respiratory Diseases, Department of Experimental and Clinical Medicine, Faculty of Medicine and Surgery, University “Magna Graecia” of Catanzaro, “Mater Domini” University Hospital, Catanzaro, Italy Of the new fluoroquinolones, levofloxacin is tonsillitis, she was prescribed levofloxacin 500 mg/ used the most in Italy despite its recent introduction day. About 12 hours after the initiation of levoflox- (1998), and it appears to be at least as safe and as acin therapy, she developed a metallic taste, blurred well tolerated as other agents in its class. [1,2] The vision and dyspnoea. most common adverse reactions with this agent in- On examination, her blood pressure was 110/ volve the gastrointestinal tract (nausea, abdominal 70mm Hg, heart rate 85 beats/min, respiratory rate pain, diarrhoea, vomiting and taste perversion) and 22 breaths/min and temperature 39.4°C. Cardio- the central nervous system (anxiety, insomnia, head- vascular and respiratory examination revealed no ache and dizziness). [1,2] No levofloxacin-related ad- signs consistent with congestive heart failure or verse events have been reported at rates higher than respiratory tract infection. Lung function evaluation 1.3%, and most of those reported were at an even showed a small but significant reduction in the lower rate. [3] forced expiratory volume in the first second (FEV 1 ) We report here the case of a young woman in from her own baseline value (table I); however, the whom oral administration of levofloxacin induced patient did not need bronchodilators or other support reversible taste perversion, blurred vision and therapies. dyspnoea. Laboratory evaluation revealed an increase in serum transaminase, erythrocyte sedimentation ve- 1. Case locity and C-reactive protein levels. Blood markers for hepatitis A, hepatitis B and hepatitis C were A 21-year-old woman (weight 48kg, height negative. In addition, she complained of significant 155cm) without a medical history of adverse drug deficits in visual fields. Specialist examination ex- reactions and with adequate renal and hepatic func- cluded a retinal detachment and supported a possible tions, was prescribed paracetamol (acetaminophen) optic neuropathy in the left eye; levofloxacin ther- 500mg/6h for 5 days because of mild fever (38.2°C) apy was therefore immediately stopped and within and tonsillar hypertrophy. Three days later, because of worsening of the fever (40°C) and evidence of 10 days the patient fully recovered.