Linezolid-induced reversible bicytopenia in a 4-year-old boy with methicillin-resistant Staphylococcus aureus bacteremia.
The authors report on a 4-year-old child with the diagnosis of tetralogy of Fallot (TOF) and infective endocarditis. Methicillin-resistant Staphylococcus aureus (MRSA) was isolated from the blood culture of the patient. While receiving imipenem, amikacin, and linezolid therapies, the boy's general condition improved, acute phase reactants decreased, and his blood culture became negative for MRSA. On his follow-up echocardiography, the vegetation had also disappeared. However, he developed progressive bicytopenia following linezolid therapy for 5 weeks. During linezolid therapy, his hemoglobin level decreased from 12.1 to 5.3 g/dL and his platelet count from 242 x 10(9) to 14 x 10(9)/L. His white blood cell count (WBC) did not decrease during linezolid therapy. Six days following termination of linezolid therapy, his hemoglobin had increased to 8.2 g/dL and platelet count to 192 x 10(9)/L. Thus, it should be kept in mind that linezolid may induce cytopenias in children. If these side effects of linezolid are known, unnecessary laboratory investigations may be prevented and cessation of the drug may be sufficient for reversal of the cytopenias.
Tavil
Betul
B
Pediatric Hematology Unit, Hacettepe University Faculty of Medicine, Ihsan Dogramaci Children's Hospital, Ankara, Turkey. betultavil@yahoo.com
Balci
Yasemin Isik
YI
Yildirim
Inci
I
Tavil
Yusuf
Y
Secmeer
Gulten
G
Ceyhan
Mehmet
M
Tuncer
Murat
M
D000081:Acetamides / Q000009:adverse effects*; D000890:Anti-Infective Agents; D016470:Bacteremia / Q000188:drug therapy; D001792:Blood Platelets / Q000187:drug effects*; D002675:Child, Preschool; D006454:Hemoglobins / Q000032:analysis / Q000187:drug effects*; D006801:Humans; D000069349:Linezolid; D008297:Male; D016106:Methicillin Resistance; D023303:Oxazolidinones / Q000009:adverse effects*; D010976:Platelet Count; D013203:Staphylococcal Infections / Q000150:complications / Q000188:drug therapy; D013211:Staphylococcus aureus / Q000187:drug effects* / Q000302:isolation & purification
D000081:Acetamides; D000890:Anti-Infective Agents; D006454:Hemoglobins; D023303:Oxazolidinones; D000069349:Linezolid