Cutaneous vasculitis associated with fluoroquinolones

Infection. 2009 Oct;37(5):466-8. doi: 10.1007/s15010-009-8437-4. Epub 2009 Aug 7.

Abstract

Cutaneous vasculitis is a clinical entity with a broad differential diagnosis, including an adverse drug reaction. It is defined as inflammation of skin blood vessel walls. During a 7-year-period, we observed three patients who developed isolated cutaneous vasculitis during antibiotic therapy of bacterial infection. All were treated with a fluoroquinolone (ciprofloxacin or levofloxacin) combined with rifampin (two cases) or flucloxacillin (three cases), respectively. In all three cases the lesions gradually resolved after treatment with the inciting fluoroquinolone had been stopped. In one patient, leukocytoclastic small-vessel vasculitis was histologically confirmed. Fluoroquinolone-associated cutaneous vasculitis consists of an isolated self-limiting disorder that is part of a systemic vasculitis, or even life-threatening disease. Clinicians should be aware of this serious adverse event because any continuation of treatment may be fatal.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Anti-Bacterial Agents / adverse effects*
  • Bacterial Infections / drug therapy
  • Drug Therapy, Combination
  • Floxacillin / therapeutic use
  • Fluoroquinolones / adverse effects*
  • Fluoroquinolones / therapeutic use
  • Humans
  • Male
  • Rifampin / therapeutic use
  • Skin Diseases / chemically induced*
  • Vasculitis / chemically induced*
  • Withholding Treatment

Substances

  • Anti-Bacterial Agents
  • Fluoroquinolones
  • Floxacillin
  • Rifampin