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Case Reports
. 2019 Oct 1;58(19):2891-2894.
doi: 10.2169/internalmedicine.2339-18. Epub 2019 Jun 27.

Relapsing Hypoglycemia Associated with Hypocarnitinemia Following Treatment with Cefcapene Pivoxil in an Elderly Man

Shogo Hanai  1 , Mitsunaga Iwata  1 , Teruhiko Terasawa  1
Affiliations
Case Reports

Relapsing Hypoglycemia Associated with Hypocarnitinemia Following Treatment with Cefcapene Pivoxil in an Elderly Man

Shogo Hanai et al. Intern Med. .

Abstract

Pivoxil-containing cephalosporins can result in symptomatic hypocarnitinemia in children. We herein report a case of an 85-year-old man at risk of carnitine deficiency who developed relapsing symptomatic hypoglycemia after treatment with cefcapene pivoxil for urinary tract infection. On admission, laboratory tests showed low blood carnitine concentrations with low normal blood ketone levels. The patient was successfully treated by the oral administration of levocarnitine and dietary modification, including aggressive consumption of meat and dairy products, and remained symptom-free for nine months after the correction of carnitine concentrations. Healthcare providers should be cautious when prescribing pivoxil-containing antimicrobials to patients at high risk of hypocarnitinemia.

Keywords: carnitine; cefcapene pivoxil; hypoglycemia.

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Conflict of interest statement

The authors state that they have no Conflict of Interest (COI).

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