Levofloxacin and furazolidone induced toxic epidermal necrosis

Abstract

Toxic epidermal necrolysis (TEN), also known as Lyell's syndrome, is a severe cutaneous drug reaction with a high mortality. Immune response is the possible cause in its pathogenesis. Levofloxacin is one of the most commonly used quinolones and has been reported to cause of TEN. On the other hand, furazolidone was proposed to augment the action of immediate hypersensitivity of levofloxacin by its cytotoxic effect and by the generation of free radicals. Here, we present a case of TEN where, levofloxacin and furazolidone were the probable cause of these adverse drug reactions.

Delayed‐type allergic reaction to furazolidone: A case report and review of the literature

“…Oral challenge was performed, and the result proved to be positive. The latest case with hypersensitivity reaction to furazolidone was documented by Varma, 9 who described a male patient developing toxic epidermal necrolysis (TEN) after taking levofloxacin and furazolidone. However, no further testing was performed to distinguish the two agents responsible for the allergic reaction.…”

“…To date, there are only eight patients with documented hypersensitivity to furazolidone in English. Of these patients, three exhibited pulmonary hypersensitivity, 3–5 two manifested contact allergy 6,7 while one had nonpigmenting fixed drug eruptions (NPFDE), 8 toxic epidermal necrolysis (TEN), 9 and serum sickness, 10 respectively. Of the eight patients, only three were reported in the last 20 years.…”

“…Oral challenge was performed, and the result proved to be positive. The latest case with hypersensitivity reaction to furazolidone was documented byVarma,9…”