利福霉素注射液引起白细胞和中性粒细胞减少

1例68岁女性患者，因患肺结核给予利福霉素0．5g，1次／d静脉滴注；异烟肼0．3g，1次／d口服；乙胺丁醇0．5g，3次／d口服。治疗前血常规正常：WBC4．91×10^9／L，N0．729。治疗12d后，WBC和N分别降至2．48×10^9／L和0．557。考虑白细胞减少可能与利福霉素有关，停用利福霉素。7d后，WBC和N恢复正常（分别为4．41×10^9／L和0．622）。再次静脉滴注利福霉素0．5g，1次／d，7d后，WBC和N分别下降至2．93×10^9／L和0．487。再次停用利福霉素，改为左氧氟沙星0．2g静脉滴注，2次／d，继续口服异烟肼和乙胺丁醇，10d后血常规恢复正常。

Leucopenia and neutropenia caused by rifamycin injection

A 68-year-old woman with pulmonary tuberculosis was administered with IV rifamycin 0.5 g once daily, oral isoniazid 0.3 g once daily, and oral ethambutol 0.5 g thrice daily. Her routine blood tests were normal （ WBC count 4.91 × 109/L, neutrophils 0. 729） before therapy. After 12 days of therapy, her WBC count and neutrophils decreased to 2.48 x 109/L and 0.557, respectively. Leucopenia and neutropenia were considered to be possibly rifamyein-related, rifamycin was discontinued. Seven days later, the woman＇s WBC count and neutrophils returned to within normal limits （4.41 × 109/L and 0. 622, respectively）. IV rifamycin 0.5 g once daily was restarted. Seven days later, her WBC count and neutrophils decreased to 2.93 × 109/L and 0. 487, respectively. rifamycin was withdrawn again and switched to IV levofloxaein 0.2 g twice daily. Isoniazid and ethambutol were continued. Ten days later, her routine blood tests were normal.