A Rare Case of Benign Intracranial Hypertension Related to Levofloxacin in a Pediatric Patient with Spondylodiscitis

Abstract

We describe a case of -13-year-old girl who developed L3-L4 spondylodiscitis by Staphylococcus aureus agent. After 2 months of levofloxacin therapy, she developed intracranial hypertension, without any evidence of intracerebral mass or hydrocephalus at CT scan and MRI. The levofloxacin therapy was stopped and the symptoms disappeared after the same days. During levofloxacin therapy, it is mandatory to know this potential complication and to screen patients by ocular fundus in case of clinical symptoms of intracranial hypertension. The mechanism of quinolone-induced intracranial hypertension is uncertain, but probably it is related to decreased CSF absorption in the subarachnoid space. The onset of intracranial hypertension is variable, after a few days or several weeks of treatment initiation. Because a misdiagnosed rose intracranial hypertension can lead to a worse visual prognosis, during levofloxacin and fluoroquinolones therapy it is mandatory to know this potential complication and to screen patients by ocular fundus in case of severe headache and/or clinical symptoms of intracranial hypertension.