利奈唑胺致全血细胞减少

1例75岁男性患者因房室传导阻滞行永久起搏器植入术,术后出现感染性心内膜炎。首先单独给予头孢哌酮钠-舒巴坦钠3.0 g1、次/12 h静脉滴注4 d,然后改为万古霉素1.0 g1、次/12 h静脉滴注3 d,最后单独应用利奈唑胺600 mg1,次/12 h静脉滴注44 d。应用利奈唑胺前实验室检查示患者外周血白细胞12.00×109/L,红细胞3.92×1012/L,血小板158×109/L,血红蛋白115 g/L。用药第19天血常规示白细胞2.81×109/L,红细胞3.39×1012/L,血小板74×109/L,血红蛋白102 g/L。其后血常规检查显示各项指标均低于正常范围,最低值如下:白细胞2.69×109/L,红细胞2.51×1012/L,血小板48×109/L,血红蛋白69 g/L。由于病情需要未停用利奈唑胺,给予重组人粒细胞集落刺激因子、琥珀酸亚铁及红细胞悬液等对症治疗。患者应用利奈唑胺共44 d。停药后18 d血常规恢复正常:白细胞5.07×109/L,红细胞3.02×1012/L,血小板156×109/L,血红蛋白102 g/L。

Pancytopenia following treatment with linezolid

A 75-year-old male patient developed infective endocarditis after a permanent pacemaker implantation for atrioventricular block.He received initially an IV infusion of cefoperazone sodium/sulbactam sodium 3.0 g every 12 hours for 4 days alone which was replaced by an IV infusion of vancomycin 1.0 g every 12 hours for 3 days and then finally was treated with an IV infusion of linezolid 600 mg every 12 hours for 44 days alone.Before administration of linezolid,laboratory tests revealed a WBC count of 12.00×109/L,a RBC count of 3.92×1012/L,a platelet（PLT） count of 158×109/L,and a Hb level of 115 g/L.However,on day 19 of treatment,routine blood testing showed the following values： WBC count 2.81×109/L,RBC count 3.39×1012/L,PLT count 74×109/L,and Hb 102 g/L.The following routine blood tests showed that complete blood cells count values were below normal and the lowest values were as follows： WBC count 2.69×109/L,RBC count 2.51×1012/L,PLT count 48×109/L,and Hb 69 g/L.Linezolid was not stopped because of the patient＇ s condition,and symptomatic treatments with recombinant human granulocyte colony-stimulating factor,ferrous succinate and red cells suspension were given.The patient received linezolid for a total of 44 days and then the drug was withdrawn.On day 18 of drug discontinuation,the results of his routine blood tests were normal： WBC count 5.07×109/L,RBC count 3.02×1012/L,PLT count 156×109/L,Hb 102 g/L.