Linezolid tedavisine bağlı gelişen pansitopeni

Ciddi çocukluk enfeksiyonlarının önemli bir bölümünü antibiyotiğe dirençli enfeksiyonlar oluşturmaktadır. Enterokok, stafilokok ve pnömokok enfeksiyonların da giderek artan bir direnç ve tedavi güçlüğü yaşanmaktadır. Linezolid, gram pozitif etkinlik gösteren klinik kullanıma yeni girmiş antibiyotiklerden biridir. Bu makalede linezolid kullanımına bağlı geri dönüşümlü kemik iliği baskılanması gelişen vankomisine dirençli enterokok enfeksiyonlu bir bebek olgu sunulmuştur. Meningomyelosel nedeniyle bir aylık iken ameliyat edilen ve hidrosefali gelişen on aylık kız hastaya şant takılmıştı. Beyin omurilik sıvısı kültüründe vankomisine dirençli Enterococcus faecium ve genişlemiş spektrumlu beta laktamaz pozitif Escherichia coli üremesi üzerine linezolid ve meropenem başlandı. Tedavinin ikinci haftasında beyin omurilik sıvısı bulguları düzeldi. Fakat kemik iliği baskılanması görüldü. Linezolid tedavisi kesildi. İzlemde kan tablosu normale döndü

Pancytopenia due to linezolid treatment

Antibiotic-resistant infections constitute a significant portion of severe childhood infections. A gradually increasing resistance and treatment difficulty are observed in infectiosn caused by enterococci, staphylococci and pneumococci. Linezolid is one of the new antibiotics which has recently been introduced for clinical use with gram positive efficiency. In this article, a pediatric patient with vancomycin-resistant enterococcus infection who developed reversible bone marrow supression related with use of linesolid was presented. A shunt was inserted in a ten-month old female patient who had been operated at the age of one month because of meningomyelocele and who had developed hydrocephalus. Linezolid and meropenem treatment was started when vancomycin-resistant Enterococcus faecium and extended-spectrum beta-lactamase positive Escherichia coli grew in cerebrospinal fluid culture. In the second week of treatment, cerebrospinal fluid findings improved. However, bone marrow supression was observed. Linezolid treatment was discontinued. In the follow-up, the blood cell counts returned to normal levels

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