Teicoplanin-induced hypersensitivity syndrome with a preceding vancomycin-induced neutropenia: a case report and literature review.
Hypersensitivity syndrome associated with teicoplanin has rarely been reported. We report a case with a preceding episode of vancomyin-related neutropenia. A 47-year-old female with cervical spine infection was treated with vancomycin. Neutropenia occurred after 17 days of vancomycin therapy. Vancomycin was changed to teicoplanin, and the neutropenia resolved 4 days later. After 11 days of teicoplanin therapy, a new episode of hypersensitivity syndrome manifested as fever, bilateral neck lymphadenopathy, mild wheezing, hepatitis and increased CRP occurred. Neutropenia and thrombocytopenia developed 3 days later. The patient's symptoms settled over 1 week following withdrawal of teicoplanin. Naranjo's ADR algorithm categorized the neutropenia associated with vancomycin and the hypersensitivity syndrome associated with teicoplanin as 'probable'.
Department of Pharmacy, National Cheng Kung University Hospital, Tainan, Taiwan.
S-H
SH
Hsiao
H-H
HH
Chen
C-H
CH
Chou
W-L
WL
Lin
P-Y
PY
Liu Yeh
T-J
TJ
Wu
D000900:Anti-Bacterial Agents / Q000009:adverse effects* / Q000627:therapeutic use; D004342:Drug Hypersensitivity / Q000209:etiology*; D005260:Female; D005334:Fever / Q000188:drug therapy / Q000209:etiology; D006801:Humans; D007239:Infections / Q000188:drug therapy; D008875:Middle Aged; D009503:Neutropenia / Q000139:chemically induced*; D013122:Spinal Diseases / Q000188:drug therapy; D017334:Teicoplanin / Q000009:adverse effects* / Q000627:therapeutic use; D014640:Vancomycin / Q000009:adverse effects* / Q000627:therapeutic use
D000900:Anti-Bacterial Agents; D017334:Teicoplanin; D014640:Vancomycin