Linezolid induced acute toxic leukoencephalopathy and severe thrombocytopenia presenting as stroke mimic—a case report

Abstract A 67-year-old lady was admitted with, right sided weakness and right arm shaking. She had recently completed a course of Linezolid for a diabetic foot infection and osteomyelitis. Prior to this she had prodromal symptoms including lethargy and loss of appetite. Clinical features prompting presentation included global weakness, verbal dysfluency and visual disturbance. MRI brain showed bilateral alteration of signal in the deep white matter of the posterior frontal and parietal lobes, sparing the superficial cortical areas. These areas showed diffusion restriction, suggestive of, but not limited to, ischaemic stroke. During admission she had a decline in consciousness and was hypertensive. An acute drop in haemoglobin and platelets occurred prompting consideration of Thrombotic Microangiopathy and other drug related/malignant/infective aetiologies. A diagnosis of Linezolid induced Acute Toxic Leukoencephalopathy and thrombocytopenia was made based on clinico-radiographic features and exclusion of other causes.

• Publication year

  2024

• Venue

  Oxford Medical Case Reports

• Publication date

  2024-12-01

• Fields of study

  Medicine

• Identifiers
  DOI 10.1093/omcr/omae150PMID 39664922PMCID 11631214
• External record

  Open on Semantic Scholar

• Source metadata

  Semantic Scholar, PubMed

• No claims are published for this paper.

• No concepts are published for this paper.

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• Population pharmacokinetics and pharmacodynamics of linezolid‐induced thrombocytopenia in hospitalized patients

  2017influential reference
• Complications associated with antibiotic administration: neurological adverse events and interference with antiepileptic drugs.

  2017cited by this paper
• Linezolid Toxicity and Mitochondrial Susceptibility: A Novel Neurological Complication in a Lebanese Patient

  2016cited by this paper
• Acute toxic leukoencephalopathy: potential for reversibility clinically and on MRI with diffusion-weighted and FLAIR imaging.

  2009cited by this paper
• Linezolid-induced posterior reversible leukoencephalopathy syndrome.

  2007cited by this paper
• Toxic leukoencephalopathy.

  2001cited by this paper

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