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[A 34-year-old man with hemorrhagic cystitis]
Trygve Brügger-Andersen1, Rolf Reiersen
1Medisinsk avdeling, Sentralsjukehuset i Rogaland, Postboks 8100, 4068 Stavanger. antb@sir.no
Summary
Penicillin can cause severe hemorrhagic cystitis and neutropenia in patients with bacterial endocarditis. Discontinuation of penicillin led to symptom resolution, highlighting antibiotic-induced adverse effects.
Area of Science:
- Pharmacology
- Infectious Diseases
- Nephrology
Background:
- A patient undergoing penicillin treatment for Streptococcus mutans endocarditis developed severe adverse effects.
- Symptoms included macroscopic hematuria, abdominal pain, dysuria, thrombophlebitis, eosinophilia, and hemorrhagic cystitis.
Observation:
- The patient's symptoms resolved after discontinuing penicillin therapy.
- Upon switching to ceftriaxone, the patient experienced reversible neutropenia.
Findings:
- Penicillin was identified as the causative agent for hemorrhagic cystitis.
- Beta-lactam antibiotics, including penicillin, are known to induce neutropenia, potentially due to cross-reactivity.
Implications:
- Hemorrhagic cystitis induced by penicillin can be a life-threatening condition.
- Awareness of potential beta-lactam antibiotic adverse effects like neutropenia is crucial for patient management.
- Prompt recognition and discontinuation of causative agents are vital for recovery.