Ofloxacin induced leucopenia in complicated falciparum malaria: a case report

INTRODUCTION To report a case of ofloxacin-associated leucopoenia, which occurred in a patient of falciparum malaria shortly after administration and resolved following discontinuation of the drug. CASE PRESENTATION A 44 year old female was admitted in circulatory shock with a diagnosis of falciparum malaria, suffering from fever, diarrhoea and vomiting. After successful resuscitation she was treated with intravenous ofloxacin for Escherichia coli induced diarrhoea. She developed acute leucopoenia that resolved after discontinuation of the drug. DISCUSSION Ofloxacin is a broad-spectrum synthetic fluoroquinolone used for a wide variety of bacterial infections. Because of the temporal relationship between ofloxacin administration and the development of leucopenia in our patient, as well as the relationship between drug withdrawal and improvement in white blood cell count, ofloxacin-associated leucopenia was suspected. This reaction was categorized as probable according to the Naranjo probability scale. We report, for the first time in the English-language literature, a case of Ofloxacin-associated leucopoenia. This association is further supported by the exclusion of other potential causes for this adverse effect. CONCLUSION Leucopoenia is a well-recognized adverse effect of several drugs. We report a case of Ofloxacin-associated leucopoenia during treatment of a patient with malaria. Healthcare personnel should be aware of this possible adverse reaction in patients treated with ofloxacin. A high degree of suspicion assumes special importance in this subgroup of critically ill patients with malaria where hematologic aberrations are common.