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

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 vancomycininduced neutropenia, and provides further evidence in support of an immunemediated mechanism.