Abstract
ADVERSE REACTIONS to the penicillins are relatively common<sup>1</sup>and are clinically expressed in various ways,<sup>2</sup>probably through different mechanisms.<sup>3</sup>An infrequent complication of penicillin therapy is agranulocytosis, first reported with the semisynthetic penicillin, methicillin.<sup>4</sup>Nafcillin (6-[2-ethoxy-l-naphthamido] penicillin) is structurally similar to methicillin. However, to our knowledge, reports of agranulocytosis resulting from nafcillin have not been published. <h3>Report of a Case</h3> A 44-year-old housewife was admitted to the Medical College of Virginia Hospitals on Sept 23, 1974, with a partially treated<i>Staphylococcus aureus</i>endocarditis with tricuspid-valve involvement and septic pulmonary emboli. On physical examination she appeared weak, but well nourished and in no acute distress. Her temperature was 39.2 C (102.6 F); blood pressure, 105/70 mm Hg; and pulse rate, 110 beats per minute. Prominent jugular pulsations ("v" waves) were noted. A grade 3/6 harsh systolic murmur was heard at the second left intercostal space. The rest
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