Doxycycline-associated agranulocytosis : a rare hematologic complication

Doxycycline, a commonly prescribed tetracycline class antibiotic, is typically well-tolerated but has infrequently been linked to severe hematologic complications such as agranulocytosis. This report details the case of a previously healthy woman in her 30s who presented with persistent fever and aseptic meningitis. Following treatment with doxycycline for suspicious of rickettsial infection, she developed severe neutropenia within four days of starting therapy. Bone marrow biopsy demonstrated hypercellularity with myeloid maturation arrest consistent with immune-mediated drug-induced agranulocytosis. Discontinuation of doxycycline and administration of granulocyte colony-stimulating factor (G-CSF) resulted in rapid normalization of neutrophil counts. This case highlights the importance of considering doxycycline as a potential cause of agranulocytosis and underscores the necessity of vigilant hematologic monitoring in patients receiving this medication.