[Drug-induced agranulocytosis. Discussion of the responsibility of metronidazole].

A case of severe agranulocytosis is reported in a 43 year old white male with Guillain-Barré syndrome. This patient was treated for an acute aspiration pneumonia and received several antibiotic regimens. An acute agranulocytosis occurred during the stay in the intensive care unit and was followed by a severe septic shock. Bone marrow aplasia was confirmed by needle aspiration. Metronidazole was withdrawn and agranulocytosis improved within three days. None of the other drugs given to the patient were withdrawn. Another bone marrow examination performed several days later revealed a markedly improved granulopoiesis. The patient died with multiple organ failure. The role of metronidazole is discussed in this case as this drug seemed highly responsible for the observed agranulocytosis.