In this chapter, we report and discuss the diagnosis and management of life-threatening infections and septic shock during acute and severe neutropenia (neutrophil count of <0.5 x 109/L) related to drug intake. This rare event, called -idiopathic agranulocytosis", remains a potentially serious adverse event of drugs due to the presence of severe deep tissue infections (e.g., pneumonia), septicemia, and septic shock in approximately two-thirds of the patients. Recently, several prognostic factors have been identified that may be helpful when identifying -frailty" patients. Old age (>65 years), septicemia or shock, metabolic disorders such as renal failure, and a neutrophil count below 0.1×109/L have been consensually accepted as poor prognostic factors. In this potentially life-threatening disorder, modern management with broad-spectrum antibiotics and hematopoietic growth factors (particularly G-CSF), is likely to improve the prognosis. Thus, with appropriate management, the mortality rate of idiosyncratic drug-induced agranulo-cytosis is currently around 5%.
|Title of host publication||Septic Shock|
|Subtitle of host publication||Symptoms, Management and Risk Factors|
|Publisher||Nova Science Publishers, Inc.|
|Number of pages||17|
|Publication status||Published - Nov 2012|
- Hematopoietic growth factor
- Idiosyncratic drug-induced agranulocytosis