替考拉宁致血小板减少

Teicoplanin-induced thrombocytopenia

1例57岁女性患者因左股骨颈骨折行髋关节置换术。术后17 d患者出现发热,20 d血培养示沃氏葡萄球菌阳性。给予替考拉宁0.4 g入0.9%氯化钠100 ml、1次/12 h静脉滴注,头孢唑肟2.0 g、2次/d口服。第4天患者双侧小腿出现瘀斑,血小板计数由249×109/L降至25×109/L。停用替考拉宁,头孢唑肟继续使用,第7天血小板计数恢复至104×109/L,瘀斑基本消退。

A 57-year-old female patient underwent total hip arthroplasty for left femoral neck fracture. On day 17 after surgery, the patient developed fever and, on day 20, her blood culture was positive for Staphylococcus warneri. She was prescribed an IV infusion of teicoplanin 0.4 g dissolved in 100 ml of 0.9% sodium chloride solution every twelve hours and oral ceftizoxime 2.0 g twice daily. On day 4, she presented with ecchymosis on her bilateral calves and her platelet count decreased from 249 × 10^9/L to 25 × 10^9/L. Teicoplanin was stopped and ceftizoxime was continued. On day 7, the platelet count returned to 104 × 10^9/L and her ecchymosis subsided basically.