Flucloxacillin and fusidic acid-associated neutropenia in a patient with periaortic abscess: rare side effects of commonly used antibiotics

BMJ Case Rep. 2015 Mar 25:2015:bcr2014208324. doi: 10.1136/bcr-2014-208324.

Abstract

The use of long-term antibiotics for deep-seated infections is very common, and is associated with many clinically significant side effects. In this report we describe the history of a 48-year-old man who attended West Suffolk Hospital with nausea and vomiting, and was subsequently found to have a deep-seated infection following his repeat aortic valve replacement. He completed a 7-week course of intravenous flucloxacillin and oral fusidic acid, however, prior to finishing this course a random blood test revealed a neutrophil count of zero. He was re-admitted to hospital with fever, and was treated accordingly as per the trust's neutropenic sepsis protocol with the addition of growth colony stimulating factor (GCSF). His neutrophil count recovered after 3 days and has remained within the normal range ever since.

Publication types

  • Case Reports

MeSH terms

  • Anti-Bacterial Agents / administration & dosage
  • Anti-Bacterial Agents / adverse effects*
  • Aortic Valve / surgery
  • Bicuspid Aortic Valve Disease
  • Fever / drug therapy
  • Fever / etiology
  • Floxacillin / administration & dosage
  • Floxacillin / adverse effects*
  • Fusidic Acid / administration & dosage
  • Fusidic Acid / adverse effects*
  • Granulocyte Colony-Stimulating Factor / therapeutic use
  • Heart Defects, Congenital / surgery*
  • Heart Valve Diseases / surgery*
  • Heart Valve Prosthesis Implantation / adverse effects*
  • Humans
  • Male
  • Middle Aged
  • Neutropenia / chemically induced*
  • Neutropenia / drug therapy
  • Sepsis / drug therapy*
  • Sepsis / etiology
  • Treatment Outcome
  • Vomiting / drug therapy
  • Vomiting / etiology

Substances

  • Anti-Bacterial Agents
  • Granulocyte Colony-Stimulating Factor
  • Floxacillin
  • Fusidic Acid