Vancomycin‐induced thrombocytopenia: a rare adverse effect in a patient ­submitted to bone graft in the jaw

Abstract

Vancomycin-induced thrombocytopenia is a rare condition, which is also a significant disorder that demands attention and the rapid identification and replacement of the antimicrobial agent.

The Incidence Rate of Vancomycin-Induced Thrombocytopenia in Orthopedics: A Single-Center Retrospective Case Series

“…Although testing for vancomycin-induced antiplatelet antibodies is the most elucidated diagnostic alternative, clinical findings cannot be underestimated in patients presenting thrombocytopenia and the associated use of vancomycin [8]. Although laboratory tests for detecting special antibodies were not performed for the cases in our research, the clinical manifestations help make the diagnosis of VIT.…”

“…Drug-induced thrombocytopenia (DIT) has been reported as an adverse reaction of over 300 medications. It is normally present 5 to 10 days after the initial exposition to the drug, or within hours after the secondary exposition to a drug that has been used in a previous occasion [8]. DIT can be caused by three mechanisms: direct toxic effect, hapten formation and the innocent-bystander immune response [9].…”

Drug-Induced Thrombocytopenia Secondary to Commonly Used Antibiotics in Total Joint Arthroplasty

“…However, the rate of VIT has not been accurately reported, and its incidence remains undetermined [17]. While VIT has been identified in other procedures [13,18], only 1 case report to our knowledge has been reported in the orthopaedic literature that involved vancomycin-impregnated cement after revision total knee arthroplasty [19]. In the all mentioned case reports, thrombocytopenia resolved upon withdrawal of vancomycin, and no further complication was reported.…”

“…While immunoassays for IgG or IgM antibodies do exist for some antibiotics [10], these tests may not be readily available to most providers. In addition, the tests require a prolonged period of treatment and may produce false negatives when DITP is recognized early in its course [12,13]. Because a delay in recognition can lead to significant morbidity and mortality, clinical criteria such as the Naranjo Adverse Drug Reaction Probability Scale [14] can help determine the probability of DITP.…”