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Azithromycin-related agranulocytosis in an elderly man with acute otitis media

Tomohiro Kajiguchi1, Toshihito Ohno

  • 1Hematology and Oncology Branch, Tosei General Hospital, Seto. tomokaji@med.nagoya-u.ac.jp

Internal Medicine (Tokyo, Japan)
|June 16, 2009
PubMed

Insights

Azithromycin can cause agranulocytosis, a severe drop in white blood cells, even in adults. Early detection and treatment are crucial for recovery from this rare side effect.

Area of Science:

  • Pharmacology
  • Hematology
  • Infectious Diseases

Background:

  • Azithromycin (AZM) is a commonly prescribed antibiotic for respiratory and ear infections.
  • While leukopenia is a known side effect in children, agranulocytosis has not been previously reported in adults.

Observation:

  • An 81-year-old male developed agranulocytosis after receiving azithromycin for acute otitis media.
  • The patient presented with febrile neutropenia and required granulocyte colony-stimulating factor and cefepim treatment.

Findings:

  • The patient's symptoms and absolute neutrophil counts fully recovered within seven days of hospitalization.
  • This case highlights a rare but serious adverse reaction to azithromycin in an adult patient.

Implications:

  • Physicians should maintain a high index of suspicion for drug-induced neutropenia in patients treated with azithromycin.
  • Prompt identification and management of azithromycin-induced agranulocytosis can prevent severe complications and mortality.

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