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Vancomycin-induced reversible pancytopenia and rash in a 16-month-old boy with osteomyelitis: A case report


Bing Leng, Genquan Yan, Tianyou Li

    International Journal of Clinical Pharmacology and Therapeutics
    |February 1, 2020
    PubMed
    Abstract

    Insights

    Vancomycin can cause reversible pancytopenia and skin rash in children, a rare side effect not previously documented in this age group. This case highlights the need for vigilance when prescribing vancomycin to pediatric patients.

    Area of Science:

    • Pediatric Pharmacology
    • Infectious Diseases
    • Hematology

    Background:

    • Vancomycin is a critical antibiotic for Gram-positive infections, including MRSA.
    • Pancytopenia is a rare but severe adverse effect associated with vancomycin therapy.
    • Previous reports of vancomycin-induced pancytopenia have been limited to adult patients.

    Observation:

    • A 16-month-old boy developed pancytopenia, pulmonary infection, and rash during vancomycin treatment for MRSA osteomyelitis.
    • These symptoms resolved after discontinuation of vancomycin.
    • This represents the first documented pediatric case of vancomycin-induced reversible pancytopenia and rash.

    Findings:

    • The patient experienced reversible pancytopenia and skin rash, suggesting a potential hypersensitivity reaction.
    • The adverse effects resolved upon vancomycin withdrawal, supporting a causal link.
    • The case was assessed as low risk for drug hypersensitivity syndrome.

    Implications:

    • Vancomycin-induced pancytopenia may be a potential complication in pediatric patients.
    • An immune-mediated mechanism is a likely cause of vancomycin-induced pancytopenia.
    • Clinicians should consider monitoring for hematologic changes in children receiving vancomycin.

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