Diagnosis and management of life-threatening infections and septic shock during idiopathic drug-induced agranulocytosis

Emmanuel Andrès*, Jacques Zimmer, Khalid Serraj, Frédéric Maloisel

*Corresponding author for this work

    Research output: Chapter in Book/Report/Conference proceedingChapterpeer-review

    1 Citation (Scopus)

    Abstract

    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%.

    Original languageEnglish
    Title of host publicationSeptic Shock
    Subtitle of host publicationSymptoms, Management and Risk Factors
    PublisherNova Science Publishers, Inc.
    Pages75-91
    Number of pages17
    ISBN (Print)9781622574858
    Publication statusPublished - Nov 2012

    Keywords

    • Agranulocytosis
    • Antibiotics
    • Hematopoietic growth factor
    • Idiosyncratic drug-induced agranulocytosis
    • Infections
    • Neutropenia

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