Ofloxacin-induced hallucinations
A 5-year-old girl was brought with a history of visual sensation of objects like helicopters and ants moving all over the room in front of her. The parents did not see any such objects. The child had a history of vomiting and loose motions since 3 days, for which she was started on ofloxacin–ornidazole combination and ondansetron by a private pediatrician. The child received three doses of the ofloxacin and ornidazole combination (Syrup Normet containing ofloxacin 50 mg and ornidazole 125 mg in 5mL) in the dose of 5mL twice a day and a single dose (5 mL) of ondensetron (Syrup Ondem containing ondensetron 4 mg in 5mL) syrup. The child did not receive oral rehydration solution or other medications for diarrhea. Vomiting subsided and the loose motions decreased in frequency. However, the same night, the child woke up screaming, saying that she could see ants crawling all over her body and in the room. She also said that she could see a helicopter flying in the room. There was no history of nightmares in the past or on that night. This lasted for 2 h and the child was brought to the hospital, where the symptoms subsided with sedation. The child was on treatment with sodium valproate and lamotrigine for seizure disorder since the last 2 years. She had been seizure-free for the past 1 year, and there had been no change in either the dose or brand of the medications in the last 1 year. There was no history of passing reddish urine, head injury or rash prior to this event. Development was normal for age. Clinical examination was essentially normal.\nInvestigations showed a random blood sugar of 65 mg/dL, serum sodium of 139 mmol/L and serum potassium of 3.5 mmol/L. Serum alanine aminotransferase was 15 U/L. The color of urine was straw-colored and routine examination and microscopy showed no albuminuria or hematuria.\nWhen the child woke up the next morning, she was no longer having the visual hallucinations but could remember the whole episode.\nA provisional diagnosis of ofloxacin-induced hallucinations was made and the parents were advised to stop the ofloxacin–ornidazole combination. Antiepileptic medications were continued. The child remained asymptomatic and she was discharged the next day.