Objective: To report a case of ticlopidine-induced neutropenia resulting in Pseudomonas bacteremia.
Case summary: An 83-year-old white man developed febrile neutropenia 5 days after initiation of ticlopidine therapy. At presentation, the patient's white blood cell count was 1.1 x 10(9)/L with an absolute neutrophil count (ANC) of 0. Ticlopidine was discontinued and the patient was treated empirically with ceftazidime, gentamicin, and filgrastim. The patient's blood cultures were positive for Pseudomonas aeruginosa. By day 6 of antibiotic and fllgrastim therapy, he was clinically improved and the ANC was 17 040 x 10(6) cells/L. The filgrastim and intravenous antibiotics were discontinued and oral ciprofloxacin was started.
Conclusions: Ticlopidine-induced neutropenia can occur suddenly and may result in a serious infection, such as bacteremia.