| Autor: |
Marraffa, Jeanna, Guharoy, Roy, Duggan, David, Rose, Frederick, Nazeer, Syed |
| Předmět: |
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| Zdroj: |
Pharmacotherapy; Sep2003, Vol. 23 Issue 9, p1195-1198, 4p, 1 Graph |
| Abstrakt: |
In a rare case of vancomycin-induced thrombocytopenia, a 50-year-old man with culture-negative subacute bacterial endocarditis underwent mitral valve replacement surgery and was treated with vancomycin. His platelet count dropped from 346 x 10³/mm³ to 13 x 10³/mm³ on postoperative day 4, and a differential diagnosis of heparin- versus drug-induced thrombocytopenia was considered. Antiheparin antibodies were detected in the patient's serum on day 5. He showed no signs of bleeding. His platelet count remained below 5 x 10³/mm³ despite two platelet transfusions on day 5. A hemorrhagic pericardial effusion with tamponade developed, requiring drainage. A trial with intravenous immunoglobulin led to fever and chills, and the infusion was not completed. Vancomycin was changed to clindamycin on day 9, and methylprednisolone therapy was started on day 11. On day 12, the patient's clinical condition improved, and his platelet count increased from 3 x 10³/mm³ to 32 x 10³/mm³ with no bleeding. On day 18, his platelet count was 424 x 10³/mm³, and he was discharged with warfarin, prednisone, and clindamycin therapy. We suspect that our patient's thrombocytopenia was due to vancomycin. [ABSTRACT FROM AUTHOR] |
| Databáze: |
Complementary Index |
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