J Korean Diabetes Assoc.  2006 Sep;30(5):403-407. 10.4093/jkda.2006.30.5.403.

A Case of Vancomycin-induced Pancytopenia in the Diabetic Patient with Infected Foot Ulcer

• Jin HY
• Jung SJ
• Park JH
• Park TS
• Back HS

• KMID: 2008271
• DOI: http://doi.org/10.4093/jkda.2006.30.5.403

Abstract

Diabetic foot ulcer is a common complication in diabetic patients and the outcome of foot ulcer depends on the severity of ulcer and combined infection such as osteomyelitis. So antibiotics targeting Gram positive cocci including Staphylococcus aureus have been used frequently. However, during the antibiotic therapy, diverse adverse reactions could be happened including red man syndrome, chest pain, hypotension, thrombocytopenia, neutropenia and drug eruption. Among these reactions, hematologic adverse events such as pancytopenia are rare and it could be lethal if happened. This article reports a case of pancytopenia associated with vancomycin in treating the diabetic patient with infected foot ulcer.

Keyword

Infected foot ulcer; Pancytopenia; Vancomycin

MeSH Terms

Anti-Bacterial Agents
Chest Pain
Diabetic Foot
Drug Eruptions
Foot Ulcer*
Foot*
Gram-Positive Cocci
Humans
Hypotension
Neutropenia
Osteomyelitis
Pancytopenia*
Staphylococcus aureus
Thrombocytopenia
Ulcer
Vancomycin
Anti-Bacterial Agents
Vancomycin

Figure

• 

  Fig. 1 A, 3 cm × 3 cm sized region was shown, which was erythematous and skin defected ulcer with offensive odor and discharge; B, Erythematous swelling with pus discharge was shown on the second toe of right foot.

• 

  Fig. 2 A, Aplain X-ray of ankle joint showed soft tissue inflammation and ulceration, but no definite bone lesion was shown; B, A plain X-ray of right foot showed bony destruction of 2nd toe and amputation state of 5th toe; C, Bone scan showed osteomyelitis wih soft tissue inflammation in right distal fibula and proximal phalange of right 2nd toe.

• 

  Fig. 3 This graph shows the changes of leukocyte, hemoglobin and platelet counts according to the antibiotics during the hospitalization periods.

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