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Vancomycin Induced Neutropenia Associated with Fever: A Case Report

Adila Shaukat, Muna Al Maslamani and Sumaira Rafiqui

Vancomycin-induced neutropenia is an uncommon but potentially serious side effect of prolonged vancomycin therapy. We present a case of a 19 year old male with disseminated methicillin-resistant Staphylococcus aureus (MRSA) Infection who was treated with IV vancomycin and developed fever and neutropenia. After discontinuation of IV vancomycin and substitution with clindamycin, both fever and neutropenia resolved within 72 h. Diagnosis of vancomycin-induced neutropenia and fever was considered as there was no alternative cause of this. In addition, quick resolution of fever and neutropenia upon removal of causative drug further supported the diagnosis. Since vancomycin is widely used in clinical practice, this adverse effect should be monitored carefully. Many studies report immune mediated mechanism to be the cause of this adverse effect. However, further studies need to be done in this regard to establish the exact mechanism.