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Marrow aplasia following topical application of chloramphenicol eye ointment
Abstract:
Chloramphenicol-induced aplastic anemia is well described in the literature following oral use of the drug. Here we describe the first case we are aware of in which chloramphenicol eye ointment resulted in severe aplastic anemia and, subsequently, death. At least two cases of marrow hypoplasia following use of chloramphenicol eyedrops have been described previously in the literature. The absorption route, its possible relation to the pathogenesis of aplastic anemia, and the two types of marrow toxicity associated with chloramphenicol are reviewed. This case emphasizes the necessity for the same careful consideration for the use of topical preparations that one affords the use of parenterally and orally administered medications.
Insights
Chloramphenicol eye ointment can cause severe aplastic anemia, leading to death. This highlights the risks of topical medications, requiring careful consideration similar to oral or injected drugs.
Area of Science:
- Hematology
- Ophthalmology
- Pharmacology
Background:
- Chloramphenicol is a known cause of aplastic anemia, typically associated with oral administration.
- Previous reports include marrow hypoplasia linked to chloramphenicol eyedrops.
Observation:
- This report details the first documented case of severe aplastic anemia and subsequent death following the use of chloramphenicol eye ointment.
- The patient developed fatal aplastic anemia after using chloramphenicol eye ointment.
Findings:
- Topical application of chloramphenicol can lead to systemic absorption and severe bone marrow toxicity.
- The pathogenesis of chloramphenicol-induced aplastic anemia, including two types of marrow toxicity, is reviewed in relation to absorption routes.
Implications:
- This case underscores the potential for severe adverse events from topical medications.
- Clinicians must exercise the same caution with topical chloramphenicol preparations as with oral or parenteral forms.
- Heightened awareness and careful prescribing of chloramphenicol eye preparations are necessary to prevent serious hematological toxicity.