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Review Article

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
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.
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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.

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