https://scholars.lib.ntu.edu.tw/handle/123456789/535559
Title: | Antithyroid-drug-induced agranulocytosis complicated by life-threatening infections | Authors: | WANG-HUEI SHENG CHIEN-CHING HUNG YEE-CHUN CHEN CHI-TAI FANG SZU-MIN HSIEH SHAN-CHWEN CHANG Hsieh W.-C. |
Issue Date: | 1999 | Publisher: | Oxford University Press | Journal Volume: | 92 | Journal Issue: | 8 | Start page/Pages: | 455-461 | Source: | QJM - Monthly Journal of the Association of Physicians | Abstract: | Agranulocytosis is a rare complication of antithyroid drugs, and the aetiologies of community-acquired, life-threatening infections in patients taking these drugs have not previously been systematically described. Of 5653 hyperthyroid patients treated with antithyroid drugs at National Taiwan University Hospital between January 1987 and December 1997, 13 (0.23%) developed agranulocytosis with life-threatening infections. The most common presentations were fever (92%) and sore throat (85%). Initial clinical diagnoses were acute pharyngitis (46%), acute tonsillitis (38%), pneumonia (15%) and urinary tract infection (8%). Positive blood cultures from six patients yielded Pseudomonas aeruginosa (3), Escherichia coli (1), Staphylococcus aureus (1), Capnocytophaga species (1). Two patients died of uncontrolled infection, thyroid storm and multiple organ failure. Cases of antithyroid-drug-induced agranulocytosis in the English language literature are reviewed; Gram-negative bacilli, including Klebsiella pneumoniae (4 patients) and P. aeruginosa (3), were the most common pathogens in clinical isolates. Our observation and review suggest that broad-spectrum antibiotics with anti-pseudomonal activity should be given to patients with antithyroid drug-induced agranulocytosis who present with severe infection. |
URI: | https://www.scopus.com/inward/record.uri?eid=2-s2.0-0032839123&doi=10.1093%2fqjmed%2f92.8.455&partnerID=40&md5=ad46b9896105cdc7de64a1d11a3f93fd https://scholars.lib.ntu.edu.tw/handle/123456789/535559 |
ISSN: | 0033-5622 | DOI: | 10.1093/qjmed/92.8.455 | SDG/Keyword: | antibiotic agent; antithyroid agent; adolescent; adult; aged; agranulocytosis; article; blood culture; Capnocytophaga; clinical article; Escherichia coli; female; fever; human; hyperthyroidism; infection; Klebsiella pneumoniae; male; mortality; multiple organ failure; pharyngitis; pneumonia; priority journal; Pseudomonas aeruginosa; sore throat; Staphylococcus aureus; thyroid crisis; tonsillitis; urinary tract infection |
Appears in Collections: | 醫學系 |
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