meropenem and Leukopenia

Emphysematous cystitis is a potentially life-threatening condition characterized by the amassing of gas within the wall of the bladder, as a result of infection by gas-forming organisms. However, the amassing of gas in the wall of the bladder does not always result from an infectious etiology. Here we report the case of a patient diagnosed with lung cancer and treated with chemotherapy, where there was air within the bladder wall accompanied by pneumoperitoneum. The presence of an infectious etiology was not clear, and the patient responded successfully to medical treatment. Although emphysematous cystitis is the most common diagnosis, the presence of gas within the wall of the bladder is a sign and not a disease per se. In our opinion, the case displays similar characteristics to those of pneumatosis cystoides intestinalis, and for this reason we refer to it as bladder pneumatosis.

Topics: Aged; Anti-Bacterial Agents; Cystitis; Emphysema; Female; Granulocyte Colony-Stimulating Factor; Humans; Leukopenia; Lung Neoplasms; Meropenem; Pneumoperitoneum; Radiography; Thienamycins

Ciprofloxacin is one of the most commonly used antibacterial agents with relatively few side effects. Serious adverse reactions reported with ciprofloxacin are rare with an incidence of 0.6%. Recently we came across two rare adverse effects of ciprofloxacin, viz. toxic epidermal necrolysis and agranulocytosis. To our knowledge, a total of seven cases have been reported in the literature documenting an association between oral ciprofloxacin administration and toxic epidermal necrolysis. One case of granulocytopenia, four of pancytopenia and fifteen of leucopenia worldwide have been reported. With the use of ciprofloxacin becoming more and more widespread, these two rare but fatal complications of ciprofloxacin should be borne in mind.

Topics: Administration, Oral; Adult; Agranulocytosis; Anti-Bacterial Agents; Anti-Infective Agents; Ciprofloxacin; Female; Granulocyte Colony-Stimulating Factor; Humans; Leukopenia; Meropenem; Neutropenia; Risk Factors; Sepsis; Stevens-Johnson Syndrome; Thienamycins