Vancomycin-associated neutropenia in hemodialysis patient wi
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Vancomycin-induced neutropenia, defined as an absolute neutrophil count (ANC) less than 1000 cells/mm3, is a rare but serious adverse reaction has been reported to occur at rates of 2–12%. The onset of neutropenia does appear to occur with prolonged treatment duration with at least seven days and mostly occurring at the 20th day after therapy initiation. Although the mechanism of action of the neutropenia is controversial, several theories have been proposed including an immunological mechanism with an IgG or IgM immune-mediated hypersensitivity reaction. A 53-year-old male admitted as a case of septic arthritis complicated with sepsis in which vancomycin-induced prolonged neutropenia occurred after nine days of therapy and was associated with toxic serum level.

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