A severe linezolid-induced rhabdomyolysis and lactic acidosis in Leigh syndrome

Although De Vries and colleagues have expressed a strong consensus for the use of linezolid in mitochondrial diseases with the only precaution of monitoring lactate levels, whenever possible we recommend avoiding this antibiotic in patients with primitive mitochondrial dysfunction. In fact, lactate monitoring hardly provides information in order to predict the development of acute severe lactic acidosis and/or rhabdomyolysis. In conclusion, our experience suggests that, for their unpredictability, it is not possible to prevent serious adverse events induced by linezolid such as those described in these fragile patients.