Linezolid-Induced Pancreatitis, Hypoglycemia, and Lactic Acidosis: Case Report and Literature Review

The triad of pancreatitis, hypoglycemia, and lactic acidosis is a rare adverse effect after linezolid administration. We report the case of a 41-year-old woman treated with oral linezolid for a filler-related Mycobacterium abscessus soft tissue infection. Three weeks after linezolid initiation, the patient presented in the emergency department, where a diagnosis of acute pancreatitis was made. Hyperlactatemia and hypoglycemia were relevant laboratory findings and potential causes were excluded. The patient rapidly deteriorated to shock and multiorgan failure, which led to patient death in 24 hours. Four similar cases have been reported, implicating linezolid-induced mitochondrial toxicity as the likely cause.