Ceftriaxone-Induced Agranulocytosis during Therapy for Streptococcus bovis Endocarditis
DOI:
https://doi.org/10.60591/crspmi.98Keywords:
Agranulocytosis/chemically induced, Ceftriaxone/ adverse effects, Endocarditis, Bacterial, Granulocyte Colony-Stimulating Factor, Streptococcal Infections, Streptococcus bovisAbstract
Ceftriaxone, one of the most frequently used antibiotics,
has agranulocytosis as one rare, but potentially serious side
effect. We report a case of ceftriaxone-induced agranulocytosis in an 85-year-old woman on the 25th day of antibiotic therapy for Streptococcus bovis (S. bovis) endocarditis that presented with a nadir of absolute neutrophil count (ANC) of 0/uL. Other potential causes were excluded. Ceftriaxone was switched to amoxicillin/clavulanate and granulocyte colony
stimulating factor (G-CSF) was prescribed, with resolution
of neutropenia in 3 days. Prolonged therapy with ceftriaxone may increase the chance of agranulocytosis, hence the importance of leukocyte monitoring in these treatment schemes. Treatment involves replacing the offending agent and the use of G-CSF until normalization of ANC.
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