Re-exposure causing rapid onset of vancomycin induced thrombocytopenia

Abstract

Vancomycin is used for the treatment of gram-positive infections. The increasing prevalence of methicillin-resistant Staphylococcus aureus since the 1980 s has led to a significant increase in the clinical utility of vancomycin in the United States. The diagnosis of vancomycin induced thrombocytopenia (VIT) poses a challenge since it requires the exclusion of other etiologies of thrombocytopenia, such as infectious or immunologic diseases and alternative drugs. Physicians should be aware that VIT is a rare but important complication of IV vancomycin therapy and failure to recognize this diagnosis may lead to a delay in discontinuation of vancomycin and serious complications

Drug-Induced Thrombocytopenia: A Case Involving Vancomycin

“…Although platelet transfusions and steroids were given to the patient in this case, significant improvement in platelet count was not seen until the discontinuation of vancomycin. This finding was compared to other case reports of vancomycin-induced thrombocytopenia, and it was consistently discovered that significant platelet recovery began following vancomycin discontinuation [ 2 , 5 - 14 ]. The normal time frame for platelet counts to return to levels greater than 150x10 3 /μL occurred between 5 and 7 days after vancomycin discontinuation.…”

“…She was then found to develop asymptomatic thrombocytopenia that resolved following the discontinuation of vancomycin despite efforts to treat it with steroids and platelet transfusions. This case involves an interesting adverse effect that is a rare occurrence with the use of vancomycin, with a reported occurrence of 7.1% in individuals being treated with vancomycin [5]. Using this case and other case reports from similar presentations, we are able to discuss and educate on the typical presentations of this adverse effect and the treatment course with the best outcomes [1,2,[6][7][8][9][10][11].…”