FATAL APLASTIC ANEMIA DUE TO STREPTOMYCIN: CASE REPORT AND BRIEF REVIEW OF PERTINENT LITERATURE

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Abstract
An uncommon manifestation of streptomycin toxicity, aplastic anemia with granulocytopenia and thrombocytopenia, occurred in a 76-yr.-old male receiving the antibiotic for pulmonary and laryngeal tuberculosis. Death resulted from sudden gastrointestinal hemorrhage on the 106th day of therapy, after 194 g. of streptomycin. Postmortem examination showed aplastic marrow without evidence of miliary tuberculosis. While on a nutritious diet with added vits., the patient developed evidence of beri-beri and pellagra during streptomycin admn. and responded to large doses of thiamine and nicotinamide. The possibility of streptomycin producing these deficiency states is discussed, and pertinent literature is briefly reviewed.