Open AccessPost-operative agranulocytosis caused by intravenous cefazolin: A case report with a discussion of the pathogenesis
Author(s) -
Lombard Charles M,
Jiali Li,
Shrestha Bijayee
Publication year - 2022
Publication title -
archives of pathology and clinical research
Language(s) - English
Resource type - Journals
ISSN - 2640-2874
DOI - 10.29328/journal.apcr.1001030
Subject(s) - cefazolin , medicine , pathogenesis , neutropenia , anesthesia , intravenous drug , bone marrow , antibiotics , surgery , chemotherapy , immunology , virus , viral disease , microbiology and biotechnology , biology
A case of post-operative agranulocytosis which occurred in a 66-year-old woman following surgery for endometrial carcinoma is reported. The agranulocytosis had a rapid onset, being detected on the first post-operative day. The causative agent, cefazolin was given to the patient intraoperatively. The agranulocytosis persisted until the 22nd postoperative day. A bone marrow biopsy performed on post-operative day four showed a left-shifted myeloid maturation pattern but not a maturation arrest. The pathogenesis of drug-induced neutropenia/agranulocytosis is discussed. It is postulated that reversible binding of cefazolin to albumin accounts for the prolonged duration of agranulocytosis.