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Drug-Induced Agranulocytosis in Elderly Patients: Diagnosis and Management of Life-Threatening Infections and Septic Shock
| Emmanuel Andrès1*, Rachel Mourot1, Olivier Keller1, Khalid Serraj2 and Thomas Vogel3 | ||
| 1Department of Internal Medicine B, University Hospital of Strasbourg, Strasbourg 67000, France | ||
| 2Department of Internal Medicine, University Hospital of Oujda, Oujda 60000, Maroc | ||
| 3Department of Internal Medicine and Geriatrics, University Hospital of Strasbourg, Strasbourg 67000, France | ||
| Corresponding Author : | Andrès E Service de Mèdecine Interne, Clinique Médicale B Hôpital Civil, Hôpitaux Universities de Strasbourg 1 Porte de l’Hôpital, 67 091 Strasbourg Cedex, France Tel: 33-3-88-11-50-66 Fax: 33-3-88-11-62-62 E-mail: emmanuel.andres@chru-strasbourg.fr |
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| Received October 15, 2014; Accepted November 26, 2014; Published December 06, 2014 | ||
| Citation: Andrès E, Mourot R, Keller O, Serraj K, Vogel T (2014) Drug-Induced Agranulocytosis in Elderly Patients: Diagnosis and Management of Life-Threatening Infections and Septic Shock . J Infect Dis Ther 2:191. doi:10.4172/2332-0877.1000191 | ||
| Copyright: © 2014 Andrès E, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. | ||
Related article at Pubmed Scholar Google |
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Abstract
In this paper, we discuss the diagnosis and management of life-threatening infections including septic shock, in elderly patients presenting with acute drug-induced neutropenia (neutrophil count of <0.5 x 109/L). Also known as “idiopathic agranulocytosis,” it remains a potentially serious adverse effect of various drugs, especially in vulnerable elderly patients. Clinical manifestations include severe deep tissue infections (e.g. pneumonia), septicemia and septic shock in approximately two-thirds of cases. Recently, several factors have been identified in order to help recognize patients with a poor prognosis. These include: Old age (>65 years), septicemia or septic shock, metabolic disorders such as renal failure and a neutrophil count below 0.1 × 109/L. 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, even in elderly patients.
