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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 A clinical diagnosis of vancomycin-induced thrombocytopaenia was made and the drug withdrawn.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.
AuthorsSimon P Rowland, Iain Rankin, Hemant Sheth
JournalBMJ case reports (BMJ Case Rep) Vol. 2013 (Oct 16 2013) ISSN: 1757-790X [Electronic] England
PMID24132444 (Publication Type: Case Reports, Journal Article)
Chemical References
  • Anti-Bacterial Agents
  • Vancomycin
Topics
  • Acute Disease
  • Anti-Bacterial Agents (adverse effects, therapeutic use)
  • Fever of Unknown Origin (drug therapy)
  • Humans
  • Male
  • Middle Aged
  • Pancreatitis (complications)
  • Platelet Count
  • Thrombocytopenia (chemically induced)
  • Vancomycin (adverse effects, therapeutic use)

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