Levamisole toxicity
Background
- an antihelminthic and immunomodulator belonging to a class of synthetic imidazothiazole derivatives that has been withdrawn from the U.S. and Canadian markets, due to the risk of serious side effects
- Increasingly used as a cutting agent in cocaine sold around the globe
- Results in Levamisole induced necrosis syndrome[1]
Clinical Features
- agranulocytosis
- neutropenia
- levamisole induced necrosis syndrome
- Necrotic patches anywhere on skin (especially ears and legs)
Differential Diagnosis
Workup
- CBC
Management
- Neutropenia
- Consider neupogen
- Observation for neutropenic fever
- Necrosis
- Aggressive supportive care
- Burn care if significant necrosis
Disposition
Admission