Severe drug eruption induced by teicoplanin, complicated by hemophagocytic syndrome: A case report and brief literature review

Abstract

A 67-year-old male was treated with ampicillin for infective endocarditis and lumbar pyogenic spondylitis caused by Enterococcus fecalis. The patient was switched to the antibacterial drug teicoplanin because of ampicillin-induced tubulointerstitial nephritis, and fever and skin rash were observed on the eighth day after the drug change. The fever and skin rash gradually resolved; however, hepatotoxicity and thrombocytopenia were observed subsequently. Owing to elevated ferritin and sIL-2R levels, a bone marrow puncture was performed, revealing hemophagocytosis, leading to a diagnosis of hemophagocytic syndrome. Although teicoplanin-induced hemophagocytic syndrome has not been previously reported and is considered rare, clinicians should be aware of its adverse effects, particularly when a severe drug eruption is accompanied by thrombocytopenia.