Life-Threatening Neutropenia 404-406
Dr. Mushtak Talib Abbas, MD, MRCP. Senior Specialist, Department of Medicine, Hamad general Hospital,PO Box 3050, Doha, Qatar.Tel.: 009745220486; fax: 009744392273; e-mail: email@example.com
We report a 57-year-old male who was admitted to the hospital with mediastinal mass which was diagnosed as a case of mediastinal abscess. Patient was started on piperacillin/tazobactam 4.5 g IV every 8 hours; plus thoracotomy and abscess drainage. On the 25th day the patient developed leucopenia, the total leukocyte count (TLC) was 1900/μl with 0% neutrophils, 87% lymphocytes and 5% eosinophils; monocyte 8%, absolute neutrophilic count (ANC) was zero, while haemoglobin and platelets remained unchanged. Suspecting antibiotic-induced neutropenia, piperacillin/tazobactam was stopped and bone marrow examination was done, which showed arrest of maturation of the granulocyte series with normal other component. Neupogen granulocyte stimulating factor (GCSF), 300 μg, subcutaneously once daily was started and the patient was transferred for reverse isolation. Neutrophils count started to rise and it reached 4200/μl on the fourth day.