Genchanok Yevgeniy, Tolu Seda S, Wang Heidy, Arora Shitij
Division of Hospital Medicine, Department of Medicine, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, NY.
Albert Einstein College of Medicine, Bronx, NY.
Perm J. 2019;23. doi: 10.7812/TPP/18-190. Epub 2019 Jun 21.
Agranulocytosis from antimicrobial therapy with ceftriaxone is rare. We report a case of agranulocytosis resulting from ceftriaxone noted more than 3 weeks into therapy.
A 72-year-old woman who was started on ceftriaxone for septic arthritis of the left knee 3 weeks before presentation was admitted to the hospital after being found to be neutropenic on outpatient laboratory analysis. Her absolute neutrophil count on admission was 0/μL. The cause of the agranulocytosis was suspected to be ceftriaxone. The drug was stopped, and she was started on granulocyte colony-stimulating factor with gradual resolution of the neutropenia.
Serious adverse effects of ceftriaxone therapy, such as agranulocytosis, must be monitored for, especially in patients who are receiving prolonged therapy or high doses. Once this cause of agranulocytosis is identified, ceftriaxone therapy should be stopped; if the patient is febrile, an infectious disease workup should be performed and antibiotics should be started; and granulocyte colony-stimulating factor should be administered with daily monitoring of the absolute neutrophil count.
头孢曲松抗菌治疗引起的粒细胞缺乏症较为罕见。我们报告一例在治疗3周多后出现的由头孢曲松导致的粒细胞缺乏症病例。
一名72岁女性，在就诊前3周因左膝脓毒性关节炎开始使用头孢曲松治疗，门诊实验室检查发现中性粒细胞减少后入院。入院时她的绝对中性粒细胞计数为0/μL。粒细胞缺乏症的病因怀疑是头孢曲松。停用该药物，并开始使用粒细胞集落刺激因子，中性粒细胞减少症逐渐缓解。
必须监测头孢曲松治疗的严重不良反应，如粒细胞缺乏症，尤其是在接受长期治疗或高剂量治疗的患者中。一旦确定粒细胞缺乏症的病因，应停止头孢曲松治疗；如果患者发热，应进行传染病检查并开始使用抗生素；应给予粒细胞集落刺激因子，并每日监测绝对中性粒细胞计数。
