title: Antithyroid drug-induced agranulocytosis complicated by pneumococcal sepsis and upper airway obstruction.
abstract: Streptococcus pneumoniae is a rare pathogen of sepsis in patients with antithyroid drug-induced agranulocytosis. We herein describe a case of antithyroid drug-induced agranulocytosis complicated by pneumococcal sepsis and upper airway obstruction. A 27-year-old woman who was previously prescribed methimazole for nine months presented with a four-day history of a sore throat. She nearly choked and was diagnosed with febrile agranulocytosis. She was successfully treated with intubation, intravenous antibiotics and granulocyte colony-stimulating factor. Her blood cultures yielded S. pneumoniae. Emergency airway management, treatment of sepsis and the administration of granulocyte colony-stimulating factor can improve the clinical course of antithyroid drug-induced pneumococcal sepsis in patients with airway obstruction.
authors.affiliation: Department of Respiratory Medicine and Internal Medicine, Akashi Medical Center, Japan.
authors.forename: Naoto
authors.initials: N
authors.lastname: Ishimaru
authors.forename: Hisashi
authors.initials: H
authors.lastname: Ohnishi
authors.forename: Teruaki
authors.initials: T
authors.lastname: Nishiuma
authors.forename: Ryota
authors.initials: R
authors.lastname: Doukuni
authors.forename: Kanoko
authors.initials: K
authors.lastname: Umezawa
authors.forename: Sachiko
authors.initials: S
authors.lastname: Oozone
authors.forename: Emi
authors.initials: E
authors.lastname: Kuramoto
authors.forename: Sho
authors.initials: S
authors.lastname: Yoshimura
authors.forename: Saori
authors.initials: S
authors.lastname: Kinami
mesh_terms: D000328:Adult; D000380:Agranulocytosis / Q000139:chemically induced* / Q000150:complications / Q000175:diagnosis*; D000402:Airway Obstruction / Q000150:complications / Q000175:diagnosis*; D013956:Antithyroid Agents / Q000009:adverse effects*; D005260:Female; D006801:Humans; D011008:Pneumococcal Infections / Q000150:complications / Q000175:diagnosis*; D018805:Sepsis / Q000150:complications / Q000175:diagnosis*
chemical_list: D013956:Antithyroid Agents