Case Report
Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Mar 6, 2021; 9(7): 1696-1704
Published online Mar 6, 2021. doi: 10.12998/wjcc.v9.i7.1696
Vancomycin-induced thrombocytopenia in endocarditis: A case report and review of literature
Si-Ri Guleng, Ri-Han Wu, Xiao-Bin Guo
Si-Ri Guleng, Ri-Han Wu, Xiao-Bin Guo, Department of Pharmacy, Inner Mongolia Autonomous Region People's Hospital, Hohhot 010010, Inner Mongolia Autonomous, China
Author contributions: Guleng SR and Wu RH collected the case information and drafted the manuscript; Guleng SR and Guo XB analyzed the data and revised the manuscript; all authors issued the final approval for the version to be submitted.
Supported by The Inner Mongolia Autonomous Region People's Hospital Training Talent Research Start-up Fund, No. BS201703.
Informed consent statement: An informed written consent was obtained from the patient for the publication of this report and any accompanying images.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
Corresponding author: Si-Ri Guleng, PhD, Chief Doctor, Department of Pharmacy, Inner Mongolia Autonomous Region People's Hospital, No. 20 Zhaowuda Road, Saihan District, Hohhot 010010, Inner Mongolia Autonomous, China.
Received: October 13, 2020
Peer-review started: October 13, 2020
First decision: December 13, 2020
Revised: December 28, 2020
Accepted: January 22, 2021
Article in press: January 22, 2021
Published online: March 6, 2021
Core Tip

Core Tip: The present report describes a case of vancomycin-induced thrombocytopenia (VIT) in endocarditis and reviews all VIT cases reported in the literature, in terms of indications, diagnosis, management, and potential molecular mechanisms. The present case highlights the importance of accurate diagnosis of VIT in endocarditis, which can be achieved through the time-to-platelet count curve and the Naranjo’s Adverse Drug Reaction Probability Scale score. The platelet count cannot be normalized simply by platelet transfusion alone, and the discontinuation of vancomycin is essential. Due to the anamnestic response to vancomycin re-exposure and the formation of vancomycin-dependent antiplatelet antibodies, the re-administration of vancomycin should be avoided.