Vancomycin-Induced Agranulocytosis and Rhinocerebral Mucormycosis in a Patient with Continuous Ambulatory Peritoneal Dialysis-Associated Peritonitis.
- Author:
Soo Jin KIM
1
;
So Young PARK
;
Young Soo SONG
;
Ji Won PARK
;
Ji Eun OH
Author Information
1. Department of Internal Medicine, College of Medicine, Hallym University, Seoul, Korea. jieunmd@hallym.or.kr
- Publication Type:Case Report
- Keywords:
Agranulocytosis;
Vancomycin;
Peritoneal Dialysis;
Rhinocerebral mucormycosis
- MeSH:
Administration, Intravenous;
Agranulocytosis*;
Amphotericin B;
Granulocyte Colony-Stimulating Factor;
Humans;
Kidney Failure, Chronic;
Leukocyte Count;
Methicillin Resistance;
Middle Aged;
Mucormycosis*;
Peritoneal Dialysis;
Peritoneal Dialysis, Continuous Ambulatory;
Peritonitis*;
Skull Base;
Staphylococcus haemolyticus;
Vancomycin
- From:Korean Journal of Nephrology
2006;25(3):515-519
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
Vancomycin-induced agranulocytosis is a rare side effect, but the increased use of vancomycin may disclose a more frequent occurrence. And it is a life-threatening complication, especially in end stage renal disease (ESRD) patients. We describe a 62-year-old patient with continuous ambulatory peritoneal dialysis (CAPD), who developed agranulocytosis after 3 weeks intraperitoneal administration of vancomycin for treatment of peritonitis caused by methicillin-resistant Staphylococcus haemolyticus. The agranulocytosis was resolved with granulocyte colony-stimulating factor (G-CSF) therapy and by the discontinuation of vancomycin. But, the patient developed subsequent rhinocerebral mucormycosis with invasion to skull base associated prolonged neutropenic period and expired in spite of surgical resection and intravenous administration of amphotericin. This case serves as a reminder to clinicians that patients receiving long-term treatment with vancomycin should have their white blood cell count monitored and vancomycin-induced agranulocytosis should be corrected promptly.
