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We describe a patient with multiple lung and skin lesions, cultures of which yielded Aspergillus species during a prolonged course of pancytopenia and agranulocytosis. Although the correlation between neutropenia and an increased risk of aspergillosis is well known, to our knowledge ours is the first case in which ticlopidine hydrochloride triggered this chain of events.

Report of a Case

A 75-year-old man presented in August 1998 with recurrent syncope, anemia (hemoglobin, 103 g/L), and neutropenia (white blood cell count, 1.3 x 10⁹/L). Ticlopidine, 250 mg twice daily, had been used for the previous 3 months for recurrent transient ischemic attacks. Progressive neutropenia and thrombopenia developed during the first week of admission (white blood cell count, 0.6 x 10⁹/L; platelet count, 14 x 10⁹/L), and a bone marrow biopsy specimen revealed severe aplasia of all cell types. The patient became febrile (temperature, 39.2°C), with a cutaneous rash and sore throat. Repeated blood . . . [Full Text of this Article]

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