Vancomycin-Associated Hemolytic Anemia in a Pediatric Patient: A Case Report

Abstract Vancomycin is associated with a rare hematologic adverse drug reaction (ADR) and immune hemolytic anemia, which has an incidence rate of 1 in 1000,000. Here, we report a case of vancomycin-associated hemolytic anemia in a pediatric patient. A 12-year-old male with morbid obesity (body mass index of 38.81 kg/m 2 ) was initially diagnosed with osteomyelitis and empirically started on vancomycin. After 3 days of therapy, hemoglobin dropped from 11.5 to 6.5 g/dL, which is more likely associated with hemolytic anemia. We used the Naranjo ADR Probability Scale as an objective measure of our assessment. Vancomycin was discontinued, and then it was shifted to clindamycin guided by culture and blood transfusions to address the severe hemolytic anemia. In this case report, an obese pediatric patient experienced adverse effects due to using vancomycin, resulting in immune hemolytic anemia. The suspected drug, vancomycin, should be discontinued in such cases to prevent further complications and ensure the safety of the pediatric population. The case report highlights the importance of monitoring the drug effects and considering unique factors that may contribute to adverse reactions in morbidly obese pediatrics.