Penicillin-Induced Agranulocytosis-A Case Report

青黴素造成的顆粒性白血球缺乏症－一病例報告

曾炳憲(Bing-Hsiean Tzeng) ； 張峰義(Feng-Yee Chang) ； 丁予安(Yu-An Ding)

《Journal of Medical Sciences》 18卷3期 (1997/12) Pp. 189-192

摘要

一位32歲感染性心內膜炎男性病患，每天靜脈注射一千八百萬單位之青黴素，三週後出現了冷顫、發燒及喉嚨痛，血液檢查顯示顆粒性白血球缺乏症：白血球數2100/mm^3含0%嗜中性球。停止使用青黴素三天後骨髓穿刺檢查顯示髓性細胞增生和顆粒球系細胞生成傾向；五至十天後，嗜中性白血球數目恢復正常。我們認為此病例顯示出對於長時間使用大劑量青黴素治療的病人密切監測白血球數是很重要的。

關鍵字

顆粒性白血球缺乏症 ； 感染性心內膜炎 ； 青黴素

並列摘要

Penicillin G sodium, 18 million units daily, was given intravenously to a 32-year-old man with bicuspid aortic valve and infective endocarditis. Three weeks later, he developed chills, fever and sore throat. Hemogram showed agranulocytosis: the white cell count showed 2100/mm^3 with 0% neutrophil. Penicillin was discontinued. Three days later, a bone marrow aspiration revealed myeloid hyperplasia with left-shifted granulopoiesis. The neutrophil counts returned to normal in 5-10 days. We believe that the case demonstrates the importance of close monitoring of the white blood cell count in patients with long-term, high dose penicillin therapy.

並列關鍵字

agranulocytosis ； infective endocarditis ； penicillin