Pseudomonas bacteremia precipitated by ticlopidine-induced neutropenia.
OBJECTIVE
To report a case of ticlopidine-induced neutropenia resulting in Pseudomonas bacteremia.


METHODS
An 83-year-old white man developed febrile neutropenia 5 days after initiation of ticlopidine therapy. At presentation, the patient's white blood cell count was 1.1 x 10(9)/L with an absolute neutrophil count (ANC) of 0. Ticlopidine was discontinued and the patient was treated empirically with ceftazidime, gentamicin, and filgrastim. The patient's blood cultures were positive for Pseudomonas aeruginosa. By day 6 of antibiotic and fllgrastim therapy, he was clinically improved and the ANC was 17 040 x 10(6) cells/L. The filgrastim and intravenous antibiotics were discontinued and oral ciprofloxacin was started.


CONCLUSIONS
Ticlopidine-induced neutropenia can occur suddenly and may result in a serious infection, such as bacteremia.
Geletko
S M
SM
College of Pharmacy, University of Rhode Island, Providence, USA.
Melbourne
K M
KM
Mikolich
D J
DJ
D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D016470:Bacteremia / Q000188:drug therapy / Q000209:etiology*; D002442:Ceftazidime / Q000627:therapeutic use; D002511:Cephalosporins / Q000627:therapeutic use; D000069585:Filgrastim; D005839:Gentamicins / Q000627:therapeutic use; D016179:Granulocyte Colony-Stimulating Factor / Q000627:therapeutic use; D006801:Humans; D008297:Male; D009503:Neutropenia / Q000139:chemically induced* / Q000150:complications; D010975:Platelet Aggregation Inhibitors / Q000009:adverse effects*; D011552:Pseudomonas Infections / Q000188:drug therapy / Q000209:etiology*; D011550:Pseudomonas aeruginosa / Q000302:isolation & purification; D011994:Recombinant Proteins; D013988:Ticlopidine / Q000009:adverse effects*
D000900:Anti-Bacterial Agents; D002511:Cephalosporins; D005839:Gentamicins; D010975:Platelet Aggregation Inhibitors; D011994:Recombinant Proteins; D016179:Granulocyte Colony-Stimulating Factor; D002442:Ceftazidime; D013988:Ticlopidine; D000069585:Filgrastim