Levofloxacin Induced Stomatitis: A Case Report

Abstract

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 toxic epidermal necrosis (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. A 36-year-old man was referred to the hospital for ‘painful oral swelling and ulceration’. Before the admission due to 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. Due to the possibility of a drug reaction, levofloxacin was discontinued and no other antibiotic was used. Oral lesions were managed with a mouthwash and after 5 days, lesions recovered. To the best of our knowledge, this is the first case who developed stomatitis after two dose of levofloxacin and recovered just with topical therapy and without any systemic treatment. Caution is advised while administering these drugs.