[Case report: severe thrombocytopenia].
In this case report, we describe the course of a chronic hemodialysis patient who has been treated for 7 days with linezolid for pneumonia caused by a methicillin-resistant staphylococcus aureus and who developed severe thrombocytopenia which was reversible after having stopped the treatment. Since there is an increasing evidence that linezolid induces severe thrombocytopenia, especially in patients requiring hemodialysis, indication for treatment with linezolid should be made with caution and monitoring of blood count in short-term intervals should be performed in critically ill patients. Linezolid is a representative of a new antibiotic class, i.e. an oxazolidinone, which inhibits the bacterial protein synthesis at the ribosom. Such agents do not have any relation to common anti-infectives and act nearly exclusively against Gram-positive bacteria and mycobacteria. In clinical practice, linezolid is most widely used for treatment of Gram-positive infections, mainly caused by methicillin-resistant Staphylococcus aureus (MRSA). The major adverse effects of linezolid are diarrhoea, nausea, and headache. Furthermore, abnormalities in blood count, i.e. leukocytopenia, thrombocytopenia and anaemia, have been reported.
Klinik für Anästhesiologie und operative Intensivmedizin, Krankenhaus Köln-Merheim. SakkaS@Kliniken-Koeln.de
Samir G
SG
Sakka
Agnes
A
Schürmann
Dirk
D
Knüttgen
Frank
F
Wappler
D000081:Acetamides / Q000009:adverse effects* / Q000627:therapeutic use; D000368:Aged; D000890:Anti-Infective Agents / Q000009:adverse effects / Q000627:therapeutic use; D006801:Humans; D000069349:Linezolid; D008297:Male; D023303:Oxazolidinones / Q000009:adverse effects* / Q000627:therapeutic use; D011023:Pneumonia, Staphylococcal / Q000188:drug therapy; D013921:Thrombocytopenia / Q000139:chemically induced* / Q000175:diagnosis / Q000517:prevention & control*
D000081:Acetamides; D000890:Anti-Infective Agents; D023303:Oxazolidinones; D000069349:Linezolid