Jennifer A Crozier, Abhisek Swaika, Nancy Vendrell and Laura Finn
Vancomycin is a glycopeptide antibiotic with widespread use since 1958. Vancomycin is clinically indicated for the treatment of methicillin-resistant strains of coagulase negative and coagulase positive staphylococcal infections, gram-positive penicillin-resistant infections and as an alternative treatment for penicillin-allergic patients. Vancomycin induced neutropenia is a rare side effect. We present the case of a 23 year old man with recurrent fevers and persistently positive blood cultures growing viridans group streptococci. He was found to have endocarditis requiring aortic valve replacement. Due to the patient’s allergies he was treated with IV vancomycin therapy. This resulted in the uncommon adverse event of vancomycin induced neutropenia. The patient subsequently responded to granulocyte colony stimulating factor. Vancomycin induced neutropenia is an uncommon but serious adverse reaction with the potential for morbidity and mortality. Further guidelines are needed for leukocyte monitoring during vancomycin therapy and the use of granulocyte colony stimulating factor to treat this adverse effect.
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