Post-operative agranulocytosis caused by intravenous cefazolin: A case report with a discussion of the pathogenesis

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Submitted: January 28, 2022
Published: Feb 18, 2022
DOI: 10.29328/journal.apcr.1001030
Keywords:
Agranulocytosis, Neutropenia, Postoperative, Cephalosporin, Cephazolin, Pathogenesis

Main Article Content

Charles M Lombard
Department of Pathology, El Camino Hospital Mountain View, CA 94040, USA
Jiali Li
Division of Hematology and Oncology, Cancer Center, El Camino Hospital Mountain View, CA, USA
Bijayee Shrestha
Department of Pathology, El Camino Hospital Mountain View, CA, USA

Abstract

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.

Article Details

Lombard, C. M., Li, J., & Shrestha, B. (2022). Post-operative agranulocytosis caused by intravenous cefazolin: A case report with a discussion of the pathogenesis. Archives of Pathology and Clinical Research, 6(1), 009–012. https://doi.org/10.29328/journal.apcr.1001030
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Copyright (c) 2022 Lombard CM, et al.

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