Vancomycin-induced reversible pancytopenia and rash in a 16-month-old boy with osteomyelitis: A case report
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OBJECTIVE

Vancomycin is a commonly used glycopeptide antibiotic due to its effectiveness in treating serious Gram-positive bacterial infections, especially methicillin-resistant Staphylococcus aureus (MRSA) infection. Pancytopenia is a rare, yet serious, complication of vancomycin. Previous isolated cases have been reported in adults but none in children.

CASE REPORT: A 16-month-old boy received vancomycin for treatment of osteomyelitis caused by MRSA. During his administration of vancomycin, reversible pancytopenia, pulmonary infection, and skin rash developed, which resolved after withdrawal.

CONCLUSION

This is the first known case of vancomycin causing reversible pancytopenia and skin rash in a child, suggesting that pancytopenia caused by vancomycin could complicate treatment of children, and the hypothesis that pancytopenia is an immune-mediated reaction seems to be preferable. According to drug hypersensitivity syndrome (DHS) risk assessment in 10-D assessment system, this case was at grade of no risk.