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Simon Nagel, MD; Martin Köhrmann, MD; Hagen B. Huttner, MD; Brigitte Storch-Hagenlocher, MD; Stefan Schwab, MD

Arch Neurol. 2007;64(5):746-748.

Objective  To describe a 71-year-old woman who developed clinical and neuroradiological features of posterior reversible leukoencephalopathy syndrome with a compromised blood-brain barrier after 5 days of intravenous linezolid therapy for an infected hip prosthesis.

Design  Case report.

Setting  Academic research.

Main Outcome Measures  Posterior reversible leukoencephalopathy syndrome was documented using serial cranial magnetic resonance imaging, and the blood-brain barrier disturbance was demonstrated by contrast enhancement of a lesion and by cerebrospinal fluid analysis.

Results  Other causes of posterior reversible leukoencephalopathy syndrome, such as renal failure, severe hypertension, inflammatory syndromes, and infectious diseases of the central nervous system, were excluded during hospitalization. After discontinuation of linezolid therapy, the patient's condition improved rapidly.

Conclusion  To our knowledge, this is the first report of likely linezolid-induced posterior reversible leukoencephalopathy syndrome with an altered blood-brain barrier after short-term intravenous therapy.

Author Affiliations: Departments of Neurology (Drs Nagel, Köhrmann, and Storch-Hagenlocher) and Neuroradiology (Dr Huttner), University of Heidelberg, Heidelberg; and Department of Neurology, University of Erlangen, Erlangen (Drs Köhrmann, Huttner, and Schwab); Germany.