Neutropenic fever induced by ticlopidine - A case report

Introduction. Neutropenia is a serious complication of ticlopidine usage. Death caused by neutropenia and thrombocytopenia secondary to ticlopidine usage has been reported. This report concerns a case of ticlopidine-induced neutropenic fever which was recognized early and treated successfully. Methods and Results. A 69-year-old woman developed neutropenic fever with agranulocytosis after 38 days of ticlopidine therapy. Owing to early suspicion of ticlopidine-induced neutropenic fever, the ticlopidine was discontinued immediately after fever onset and the patient's critical condition was fortunately soon reversed under treatment with empirical antibiotics and granulocyte colony-stimulating factor. Conclusion. This case is an alert to monitor the white cell count with differentials closely for patients using ticlopidine to avoid serious hematologic complications. Early recognition of the symptoms of such complications of ticlopidine and early discontinuation of its usage are mandatory for improving the outcome of ticlopidine-associated neutropenic fever.