Journal List > J Korean Diabetes Assoc > v.30(5) > 1062404

Jin, Jung, Park, Park, and Back: A Case of Vancomycin-induced Pancytopenia in the Diabetic Patient with Infected Foot Ulcer

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.

Figures and Tables

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.
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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.
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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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Table 1
Laboratory Examinations During Hospitalization
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