Koo K B, Bachand R L, Chow A W
Drug Intell Clin Pharm. 1986 Oct;20(10):780-2. doi: 10.1177/106002808602001010.
A case of vancomycin-induced neutropenia is presented with a review of other reported cases in the literature. A 59-year-old white female was started on vancomycin therapy for a chronic infection of a total left hip replacement. After 38 days of treatment, the patient developed a severe leukopenia with a white blood cell count of 1700/mm3 and the presence of only occasional neutrophils. Upon discontinuation of vancomycin, the leukocyte and neutrophil counts promptly increased with full recovery in one week. Subsequently, the patient was restarted on a five-day course of vancomycin at a lower dose that proved uneventful with no recurrence of neutropenia. It is unclear whether the neutropenia would have recurred with a longer course of vancomycin. A review of the literature suggests that an immunologic mechanism may be responsible for the reaction. Physicians and other health professionals should be aware that neutropenia is a potential reaction of patients receiving prolonged vancomycin treatment.
本文报告了一例万古霉素诱发的中性粒细胞减少症病例，并对文献中其他报道的病例进行了综述。一名59岁的白人女性因全左髋关节置换术后慢性感染开始接受万古霉素治疗。治疗38天后，患者出现严重白细胞减少，白细胞计数为1700/mm³，仅偶尔有中性粒细胞。停用万古霉素后，白细胞和中性粒细胞计数迅速增加，一周内完全恢复。随后，患者以较低剂量重新开始了为期五天的万古霉素疗程，结果平稳，未出现中性粒细胞减少症复发。尚不清楚使用更长疗程的万古霉素中性粒细胞减少症是否会复发。文献综述表明，免疫机制可能是该反应的原因。医生和其他卫生专业人员应意识到，中性粒细胞减少症是接受长期万古霉素治疗患者的潜在反应。
