Ceftazidime-Induced Agranulocytosis: A Case Report

The most common adverse events associated with ceftazidime include hypersensitivity reactions, gastrointestinal disturbances, and transient abnormal liver function tests, whereas neutropenia is a rare complication. We present a case of ceftazidime-induced agranulocytosis in an 89-year-old Chinese woman who presented with right upper quadrant abdominal pain, nausea, and vomiting. Imaging confirmed choledocholithiasis, cholecystitis, and hepatic cysts, and laboratory tests revealed elevated inflammatory markers. Treatment with intravenous ceftazidime initially improved her symptoms and inflammatory markers; however, severe neutropenia subsequently developed, progressing to agranulocytosis. After excluding other potential causes, ceftazidime was discontinued, and granulocyte colony-stimulating factor (G-CSF) was administered, leading to hematological recovery. This case underscores that ceftazidime, albeit rarely, can cause severe drug-induced agranulocytosis. Clinicians should consider this possibility in cases of unexplained cytopenia, as prompt drug cessation and G-CSF therapy may facilitate timely hematological recovery.