Documented vancomycin-induced severe immune-mediated thrombocytopaenia

BMJ Case Rep. 2018 Aug 27:2018:bcr2018224682. doi: 10.1136/bcr-2018-224682.

Abstract

A 69-year-old man developed Propionibacterium acnes left knee hardware infection after suffering from an infected ingrown toenail. The hardware was removed and he was treated with intravenous vancomycin. Ten days after initiation of vancomycin, he developed severe thrombocytopaenia, epistaxis and petechiae. Vancomycin was discontinued, and platelets rapidly recovered. Serum vancomycin IgG were positive. Patient completed a 6-week course of ceftriaxone with no further complications.

Keywords: bone and joint infections; drugs: infectious diseases; haematology (incl blood transfusion); infections; unwanted effects / adverse reactions.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Anti-Bacterial Agents / adverse effects*
  • Anti-Bacterial Agents / therapeutic use
  • Arthroplasty, Replacement, Knee*
  • Ceftriaxone / therapeutic use
  • Epistaxis / chemically induced
  • Gram-Positive Bacterial Infections / drug therapy*
  • Humans
  • Male
  • Nail Diseases / drug therapy*
  • Nail Diseases / microbiology
  • Nail Diseases / surgery
  • Nails / microbiology
  • Platelet Count
  • Postoperative Complications / drug therapy*
  • Postoperative Complications / microbiology
  • Propionibacterium acnes / isolation & purification
  • Thrombocytopenia / chemically induced*
  • Treatment Outcome
  • Vancomycin / adverse effects*
  • Vancomycin / therapeutic use

Substances

  • Anti-Bacterial Agents
  • Vancomycin
  • Ceftriaxone