Clinical therapeutics · 2025
Leukocytoclastic Vasculitis and Profound Cytopenias Following Teicoplanin Therapy: A Case Report on Glycopeptide Cross-Reactivity.
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Wei Qimei, Jiang Wen, Chen Xinshuang, Cai Hao, Feng Rui, Dong Shanshan
Аннотация
PURPOSE: To report a case of teicoplanin-induced leukocytoclastic vasculitis with concurrent bicytopenia.
METHODS: A 61-year-old male with penicillin allergy and postaortic valve replacement was switched from vancomycin to teicoplanin for Enterococcus faecalis endocarditis due to renal impairment concerns.
FINDINGS: On day 9 of teicoplanin therapy, pruritic maculopapular eruptions developed alongside neutropenia (absolute neutrophil count 1.5 × 10⁹/L) and thrombocytopenia (platelets 152 × 10⁹/L). After drug discontinuation, platelet count further declined to a nadir of 5 × 10⁹/L, requiring transfusions. Clinical recovery paralleled rash resolution.
IMPLICATIONS: This case highlights the risks of glycopeptide cross-reactivity and the importance of close hematologic monitoring.
METHODS: A 61-year-old male with penicillin allergy and postaortic valve replacement was switched from vancomycin to teicoplanin for Enterococcus faecalis endocarditis due to renal impairment concerns.
FINDINGS: On day 9 of teicoplanin therapy, pruritic maculopapular eruptions developed alongside neutropenia (absolute neutrophil count 1.5 × 10⁹/L) and thrombocytopenia (platelets 152 × 10⁹/L). After drug discontinuation, platelet count further declined to a nadir of 5 × 10⁹/L, requiring transfusions. Clinical recovery paralleled rash resolution.
IMPLICATIONS: This case highlights the risks of glycopeptide cross-reactivity and the importance of close hematologic monitoring.