Vancomycin-induced thrombocytopenia in endocarditis:A case report and review of literature  

作　　者：Si-Ri Guleng Ri-Han Wu Xiao-Bin Guo 

机构地区：[1]Department of Pharmacy,Inner Mongolia Autonomous Region People's Hospital,Hohhot 010010,Inner Mongolia Autonomous,China

出　　处：《World Journal of Clinical Cases》2021年第7期1696-1704,共9页世界临床病例杂志

基　　金：The Inner Mongolia Autonomous Region People's Hospital Training Talent Research Start-up Fund,No.BS201703.

摘　　要：BACKGROUND Thrombocytopenia is a serious complication in the medical practice of numerous drugs.Vancomycin is frequently used for the prophylaxis and treatment of suspected or identified methicillin-resistant positive infections.Several cases with vancomycin-induced thrombocytopenia(VIT)have been reported.However,these have rarely been extensively reviewed.The present report describes a case of VIT in endocarditis,and reviews all VIT cases reported in the literature.CASE SUMMARY A 26-year-old male diagnosed with infective endocarditis was admitted.The patient was treated with multiple drugs,including vancomycin,which was initially intravenously given at 1000 mg every 12 h and subsequently at 500 mg every 8 h on day 3.On day 11,the platelet count decreased to 51×10^(9)/L,vancomycin was switched to 500 mg every 12 h,and platelet transfusion was given.On day 17,the platelet count dropped to 27×10^(9)/L,and platelet transfusion was administered again.On day 23,vancomycin was adjusted to 500 mg every 8 h as the trough concentration dropped to the minimum effective concentration.On day 33,the platelet count declined to approximately 40×10^(9)/L.After platelet transfusion,the platelet count rebounded to 90×10^(9)/L on day 35 but dropped again to 42×10^(9)/L on day 43.Based on the time-to-platelet count curve and Naranjo’s Adverse Drug Reaction Probability Scale score,VIT was suspected.After vancomycin discontinuation and platelet transfusion,the platelet count gradually normalized.CONCLUSION The diagnosis of VIT can be achieved through the time-to-platelet count curve and Naranjo’s Adverse Drug Reaction Probability Scale score.The platelet count cannot be normalized simply by platelet transfusion alone,and vancomycin discontinuation is essential.

关 键 词：Case report VANCOMYCIN THROMBOCYTOPENIA ENDOCARDITIS Platelet transfusion Literature review 

分 类 号：R558.2[医药卫生—血液循环系统疾病] R542.41[医药卫生—内科学]