Moxifloxacin-associated neutropenia in a cirrhotic elderly woman with lower extremity cellulitis.
OBJECTIVE
To report a case of moxifloxacin-associated neutropenia in a cirrhotic patient with cellulitis.


METHODS
A 77-year-old cirrhotic woman developed cellulitis of the right leg, with a nadir white blood cell (WBC) count of 1.5 x 10(3)/microL and absolute neutrophil count (ANC) of 0.345 x 10(3)/microL, which occurred after 5 days of moxifloxacin therapy. Moxifloxacin was switched to cefixime and neutropenia resolved 2 days after the withdrawal of moxifloxacin.


CONCLUSIONS
Cases of neutropenia related to fluoroquinolones have rarely been reported in the literature, and neutropenia associated with moxifloxacin has not been described before. Because of the temporal relationship between moxifloxacin administration and the development of neutropenia in our patient, as well as the relationship between drug withdrawal and improvement in WBC count and ANC, moxifloxacin-associated neutropenia was suspected. This reaction was categorized as probable according to the Naranjo probability scale.


CONCLUSIONS
We report the first case of moxifloxacin-associated neutropenia. Although such an adverse reaction is rare, clinicians should be aware of this potential complication of moxifloxacin therapy.
Chang
Chia-Ming
CM
Divisions of Infectious Diseases, Geriatrics, and Gerontology, Department of Internal Medicine, National Cheng Kung University Hospital, Tainan, Taiwan.
Lee
Nan-Yao
NY
Lee
Hsin-Chun
HC
Lee
I-Wen
IW
Wu
Chi-Jung
CJ
Lin
Yu-Shiuan
YS
Ko
Wen-Chien
WC
D000368:Aged; D000842:Ankle; D000890:Anti-Infective Agents / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D001372:Aza Compounds / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D001772:Blood Cell Count; D002481:Cellulitis / Q000150:complications / Q000188:drug therapy*; D005260:Female; D024841:Fluoroquinolones; D006801:Humans; D008103:Liver Cirrhosis / Q000150:complications*; D000077266:Moxifloxacin; D009503:Neutropenia / Q000139:chemically induced*; D011804:Quinolines / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use
D000890:Anti-Infective Agents; D001372:Aza Compounds; D024841:Fluoroquinolones; D011804:Quinolines; D000077266:Moxifloxacin