Vancomycin-induced neutropenia with fever

Vancomycin is a glycopeptide antibiotics acts by inhibiting cell well and is used for the treatment of resistant Gram-positive bacteria. Vancomycin-induced fever with neutropenia is not commonly encountered in our clinical practice, it can lead to diagnostic dilemmas during the course of management. We report the case of a 43-year-old female with infective endocarditis of the aortic valve, who was started empirically on vancomycin and ceftriaxone. She later developed fever with neutropenia following 2 weeks of intravenous antibiotics. This was attributed to the rare adverse effect of vancomycin, after further investigating and ruling out all other possible etiologies. After discontinuing vancomycin, the symptoms resolved rapidly. Although the exact mechanism of the fever and neutropenia is not known, many researchers believe it to be immune mediated.