Abstract
Moxifloxacin is commonly prescribed in the inpatient and outpatient management of community-acquired pneumonia and other common infections. We report a case of a 76-year-old man who developed severe neutropenia after several days of treatment for community-acquired pneumonia. The patient had a history of alcohol abuse; however, there were no other offending medications prescribed, and a thorough laboratory workup for other possible causes of neutropenia was negative. The patient’s neutrophils and white blood count responded quickly to cessation of fluoroquinolones. This case highlights the importance of identifying patients that might be at high risk for neutropenia that may need closer monitoring on this commonly prescribed medication.
Highlights
DiscussionThe patient’s presentation was consistent with moxifloxacin-induced leukopenia. He presented with a normal white blood cell count (WBC) count, there was a notable macrocytic anemia
A 76-year-old Hispanic male with a history of alcohol abuse, homelessness, and remote history of multiple stab wounds in the 1980s was brought to the hospital by friends due to fever, increased lethargy, and cough for the past 4 days
There was continued leukopenia following exposure to ciprofloxacin and azithromycin, and these were discontinued with a subsequent recovery of his white blood cell count (WBC) count
Summary
The patient’s presentation was consistent with moxifloxacin-induced leukopenia. He presented with a normal WBC count, there was a notable macrocytic anemia. Chang et al reported the first case of moxifloxacin-induced neutropenia in an elderly cirrhotic woman being treated for cellulitis Their workup was negative for bacterial or viral pathogens. This, in addition to a case of neutropenia possibly caused by norfloxacin, provides support that neutropenia[6] is not unique to moxifloxacin, but may be an adverse effect of the fluoroquinolone antibiotic class. Because this was the patient’s first visit in our hospital system, and there was no information regarding the patient’s baseline
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