London Health Sciences Centre.
Can J Infect Dis Med Microbiol. 2005 Sep;16(5):286-8. doi: 10.1155/2005/961613.
A 75-year-old male outpatient with cardiac disease, diabetes, chronic renal insufficiency and iron deficiency anemia was prescribed linezolid 600 mg twice daily for a methicillin-resistant Staphylococcus aureus diabetic foot osteomyelitis. After one week, his blood counts were consistent with baseline values. The patient failed to return for subsequent blood work. On day 26, he was admitted to hospital with acute renal failure secondary to dehydration, and was found to be pancytopenic (erythrocytes 2.5x10(12)/L, leukocytes 2.9x10(9)/L, platelets 59x10(9)/L, hemoglobin 71 g/L). The patient was transfused, and linezolid was discontinued. His blood counts improved over the week and remained at baseline two months later.The patient's decline in blood counts from baseline levels met previously established criteria for clinical significance. Application of the Naranjo scale indicated a probable relationship between pancytopenia and linezolid.Clinicians should be aware of this rare effect with linezolid, and prospectively identify patients at risk and emphasize weekly hematological monitoring.
一位 75 岁的男性门诊患者，患有心脏病、糖尿病、慢性肾功能不全和缺铁性贫血，被开处利奈唑胺 600mg，每日两次，用于治疗耐甲氧西林金黄色葡萄球菌糖尿病足骨髓炎。一周后，他的血液计数与基线值一致。患者未能返回进行后续血液检查。第 26 天，他因脱水导致急性肾衰竭住院，并发现全血细胞减少（红细胞 2.5x10(12)/L，白细胞 2.9x10(9)/L，血小板 59x10(9)/L，血红蛋白 71g/L）。患者接受了输血，并停用了利奈唑胺。他的血液计数在一周内有所改善，两个月后仍保持在基线水平。患者的血液计数从基线水平下降符合先前确定的临床意义标准。Naranjo 量表的应用表明全血细胞减少与利奈唑胺之间可能存在关联。临床医生应意识到利奈唑胺存在这种罕见的副作用，应前瞻性地识别有风险的患者，并强调每周进行血液学监测。
