A Fatal Case of Ciprofloxacin-induced Fulminant Hepatitis.

UNLABELLED: Fatal hepatotoxicity associated with ciprofloxacin is extremely rare. This is the second fully investigated case of fulminant hepatotoxicity due to ciprofloxacin in a male patient previously ciprofloxacin tolerant. The patient's medical history included stable Waldenstrom's macroglobulinaemia, inguinal hernia repair, prostate cancer (radiotherapy in 2006) and idiopathic Parkinson's disease. Extensive investigation for progressive liver failure confirmed drug-induced liver injury.

LEARNING POINTS: Idiosyncratic drug-induced liver injury is rare, so a history of consumption of any potentially offending drug is vital.Exhaustive searches for alternative causes are imperative and a comprehensive history is essential, including a travel history with microbiological investigations if necessary; potential drug-induced liver injury must always be considered.The patient's age and past medical history may affect outcome.