Linezolid is an oxazolidinone antibiotic. Linezolid-associated lactic acidosis has been reported in 6.8% of linezolid-treated patients. Lactic acidosis is associated with poor clinical outcomes, with high blood lactate levels resulting in organ dysfunction and mortality. This case report describes the development of lactic acidosis in a 64-year-old Chinese woman who had received 33 days of treatment with antituberculosis drugs and 28 days of treatment with oral linezolid for tuberculous meningitis. Severe lactic acidosis was reversed by withdrawing antituberculosis drugs and using continuous venovenous hemodiafiltration (CVVH). When the patient's condition was stable, she was transferred to the infectious disease department, and antituberculosis drugs, with the exception of linezolid, were reintroduced. This did not result in recurrence of lactic acidosis. The causal relationship between lactic acidosis and linezolid was categorized as 'probable' on the Adverse Drug Reaction Probability Scale. This case demonstrates that CVVH has potential as an alternative to discontinuation of linezolid alone for rapid reversal of linezolid-associated severe lactic acidosis.
Keywords: ADR, Adverse Drug Reaction; APTT, activated partial thromboplastin time; CRRT, continuous renal replacement therapy; CVVH; CVVH, continuous venovenous hemodiafiltration; Case report; ESRD, end-stage renal disease; FIB, fibrinogen; ICU, intensive care unit; Lactic acidosis; Linezolid; PT, prothrombin time; PaCO2, arterial partial pressure of carbon dioxide; PaO2, arterial partial pressure of oxygen; TT, thrombin time.
© 2021 The Author(s).