Vancomycin-induced neutropenia associated with fever: similarities between two immune-mediated drug reactions

Pharmacotherapy. 1999 Feb;19(2):240-4. doi: 10.1592/phco.


A 39-year-old woman being treated for osteomyelitis with vancomycin developed severe neutropenia and drug fever. After she discontinued therapy, both disorders quickly resolved. These adverse reactions have rarely been reported with vancomycin, and share many similarities with regard to clinical features and postulated mechanisms of induction. To our knowledge this is the first case documenting drug fever as a principal component of vancomycin-induced neutropenia, and provides further evidence in support of an immune-mediated mechanism.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Adult
  • Aged
  • Anti-Bacterial Agents / adverse effects*
  • Anti-Bacterial Agents / therapeutic use
  • Child
  • Child, Preschool
  • Female
  • Fever / chemically induced*
  • Fever / immunology
  • Humans
  • Male
  • Middle Aged
  • Neutropenia / chemically induced*
  • Neutropenia / immunology
  • Osteomyelitis / drug therapy
  • Vancomycin / adverse effects*
  • Vancomycin / therapeutic use


  • Anti-Bacterial Agents
  • Vancomycin