08 June 2021: Articles
Neutropenia, Thrombocytopenia, and Eosinophilia: An Unusual Triad in a Patient on Long-Term Vancomycin Therapy
Unusual clinical course, Adverse events of drug therapy
Hendrik Lintel A* , Mohammad Saffaf ADOI: 10.12659/AJCR.931647
Am J Case Rep 2021; 22:e931647
Table 1. Complete blood count results with differentials and creatinine levels in the patient corresponding with antibiotic regimen.
| Laboratory test | Vancomycin | ||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Day 1 | Day 2 | Day 3 | Day 5 | Day 12 | Day 13 | Day 19 | Day 26 | Day 33 | Day 34 | Day 35 | Day 36 | Day 37 | Day 38 | Day 40 | |
| White blood cells (10/uL) | 12.9 | 18.5 | 17.7 | 13.9 | 8.2 | 8.3 | 7.2 | 4.8 | 0.9 | 1.2 | 1.7 | 2.3 | 3.2 | 3.7 | 5 |
| Hemoglobin (g/dL) | 12.5 | 11.1 | 12.3 | 10.5 | 10.2 | 10.5 | 11.1 | 11.4 | 11.2 | 10.8 | 11.1 | 9.8 | 10.2 | 10.3 | 11.2 |
| Hematocrit (%) | 37.5 | 32.9 | 37.5 | 32.1 | 31.5 | 32.1 | 35 | 35.5 | 34.6 | 33.6 | 34.5 | 30.8 | 32.6 | 31.5 | 35.6 |
| Platelets (10/uL) | 377 | 335 | – | 333 | 307 | – | 261 | 189 | 126 | 135 | 168 | 172 | 210 | 215 | 250 |
| Neutrophils (%) | 67% | 84% | 75% | 61% | 50% | – | – | 38% | 22% | 13% | 16% | 39% | 41% | 50% | 47% |
| Eosinophils (%) | 2% | – | 0% | 7% | 12% | – | – | 13% | 38% | 20% | 29% | 20% | 17% | 16% | 12% |
| Neutrophils absolute (10/uL) | 8.7 | 15.54 | 13.3 | 8.5 | 4.1 | – | – | 1.8 | 0.24 | 0.16 | 0.43 | 0.94 | 1.3 | 1.85 | 2.3 |
| Eosinophils absolute (10/uL) | 0.24 | – | 0.07 | 0.92 | 0.94 | – | – | 0.63 | 0.34 | 0.24 | 0.49 | 0.46 | 0.56 | 0.59 | 0.6 |
| Creatinine (mg/dL) | 0.6 | 0.6 | 0.7 | 0.7 | 0.7 | 0.6 | 0.6 | 0.7 | 0.5 | – | – | – | – | – | 0.7 |
| Vancomycin 1250 mg q12h | |||||||||||||||
| Daptomycin 10 mg/kg q24h | |||||||||||||||
| Ceftriaxone 2 g q24h | |||||||||||||||
| Cefepime 2 g q8h | |||||||||||||||
| Metronidazole 500 mg q8h | |||||||||||||||