title: Vancomycin-induced thrombocytopaenia in a patient with severe pancreatitis.
abstract: Vancomycin-induced thrombocytopenia is a rare side effect of a commonly used drug that may cause life-threatening disease. A 51-year-old man was treated for an episode of acute severe alcohol-induced pancreatitis complicated by development of a peripancreatic fluid collection. He developed fever of unknown origin and was treated with intravenous vancomycin and piperacillin with tazobactam. On day 6 of vancomycin therapy his platelet count dropped to 46×10(9)/L (237×10(9)/L on day 1 of treatment) and by day 8 of therapy platelets had fallen to a nadir of 9×10(9)/L. The patient at this stage displayed a florid purpuric rash and haematoma formation on attempted intravenous cannulation. A clinical diagnosis of vancomycin-induced thrombocytopaenia was made and the drug withdrawn. After 3 days a significant improvement in the platelet count was noted, rising to 56 × 10(9)/L. Immunofluorescence testing (PIFT) ruled out teicoplanin and heparin as causes of drug-induced thrombocytopenia.
authors.affiliation: Imperial College London, London, UK.
authors.forename: Simon P
authors.initials: SP
authors.lastname: Rowland
authors.forename: Iain
authors.initials: I
authors.lastname: Rankin
authors.forename: Hemant
authors.initials: H
authors.lastname: Sheth
mesh_terms: D000208:Acute Disease; D000900:Anti-Bacterial Agents / Q000009:adverse effects* / Q000627:therapeutic use; D005335:Fever of Unknown Origin / Q000188:drug therapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D010195:Pancreatitis / Q000150:complications*; D010976:Platelet Count; D013921:Thrombocytopenia / Q000139:chemically induced*; D014640:Vancomycin / Q000009:adverse effects* / Q000627:therapeutic use
chemical_list: D000900:Anti-Bacterial Agents; D014640:Vancomycin