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Published on: December 10, 2016
Austrian syndrome, ceftriaxone-induced agranulocytosis and COVID-19
James Edward McCulloch1, Alexandra Miller2, Marius Borcea3
1Intensive Care, Yeovil District Hospital NHS Foundation Trust, Yeovil, UK james_mcculloch@hotmail.com.
Abstract:
We present a case of a 75-year-old woman with Austrian syndrome: pneumonia, meningitis and endocarditis all due to Streptococcus pneumoniae Transoesophageal echocardiogram demonstrated a large mitral valve vegetation with severe mitral regurgitation. She was treated with intravenous ceftriaxone and listed for surgical repair of her mitral valve. Preoperatively, she developed an idiosyncratic drug-induced agranulocytosis secondary to ceftriaxone, which resolved on cessation of the medication. However, while awaiting neutrophil recovery, she developed an acute deterioration, becoming critically unwell. This deterioration was multifactorial, with acute decompensated heart failure alongside COVID-19. After multidisciplinary discussion, she was considered too unwell for surgery and palliated.
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