{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,28]],"date-time":"2026-07-28T14:08:20Z","timestamp":1785247700797,"version":"3.55.0"},"reference-count":12,"publisher":"BMJ","issue":"7","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2026,4,21]]},"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:p>Fixed drug eruption is a distinctive cutaneous adverse drug reaction characterised by the recurrence of well-demarcated lesions at the same anatomical site following re-exposure to the offending drug, with residual hyperpigmentation after resolution. Antimicrobials are common triggers, although fluoroquinolones are less frequently implicated. A man in his 30s developed multiple well-defined hyperpigmented patches involving the upper lip, upper limbs and foot within 24 hours of receiving levofloxacin for a lower respiratory tract infection. The lesions were pruritic, non-tender and recurrent at previously affected sites. Clinical findings and a clear temporal relationship supported the diagnosis of fixed drug eruption. Withdrawal of levofloxacin and symptomatic treatment resulted in gradual resolution with post-inflammatory hyperpigmentation. Causality assessment using the Naranjo scale suggested a probable association. This case highlights the importance of recognising fixed drug eruption caused by commonly prescribed antibiotics and the role of careful drug history taking and adverse drug reaction reporting.<\/jats:p>","DOI":"10.1136\/bcr-2026-273816","type":"journal-article","created":{"date-parts":[[2026,7,28]],"date-time":"2026-07-28T13:30:20Z","timestamp":1785245420000},"page":"e273816","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Levofloxacin-induced fixed drug eruption"],"prefix":"10.1136","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3549-1132","authenticated-orcid":false,"given":"Shruti Vihang","family":"Brahmbhatt","sequence":"first","affiliation":[{"name":"Pharmacology, SBKS Medical Institute and Research Centre, Waghodia, Gujarat, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-9768-2322","authenticated-orcid":false,"given":"Malay Jayantigiri","family":"Goswami","sequence":"additional","affiliation":[{"name":"Pharmacology, SBKS Medical Institute and Research Centre, Waghodia, Gujarat, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mahavir Singh","family":"Rajput","sequence":"additional","affiliation":[{"name":"Department of Physiology, SBKS Medical Institute and Resarch Centre, Waghodia, Gujarat, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3065-0974","authenticated-orcid":false,"given":"Rashmi","family":"Mahajan","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Venereology and Leprology, Sumandeep Vidyapeeth Deemed to be University, Vadodara, Gujarat, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2026,7,28]]},"reference":[{"key":"2026072806301151000_19.7.e273816.1","first-page":"201","article-title":"Fixed drug eruption: a disease mediated by self-inflicted responses of intraepidermal T cells","volume":"17","author":"Shiohara","year":"2007","journal-title":"Eur J Dermatol"},{"key":"2026072806301151000_19.7.e273816.2","doi-asserted-by":"crossref","unstructured":"Griffiths CE , Barker J , Bleiker TO , et al , eds. 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