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Sheldon M. Markowitz, MD; Michael Rothkopf, MD; Forrest D. Holden, MD; Drury M. Stith, MD; Richard J. Duma, MD

JAMA. 1975;232(11):1150-1152.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

ADVERSE REACTIONS to the penicillins are relatively common¹ and are clinically expressed in various ways,² probably through different mechanisms.³ An infrequent complication of penicillin therapy is agranulocytosis, first reported with the semisynthetic penicillin, methicillin.⁴ Nafcillin (6-[2-ethoxy-l-naphthamido] penicillin) is structurally similar to methicillin. However, to our knowledge, reports of agranulocytosis resulting from nafcillin have not been published.

Report of a Case

A 44-year-old housewife was admitted to the Medical College of Virginia Hospitals on Sept 23, 1974, with a partially treated Staphylococcus aureus endocarditis with tricuspid-valve involvement and septic pulmonary emboli. On physical examination she appeared weak, but well nourished and in no acute distress. Her temperature was 39.2 C (102.6 F); blood pressure, 105/70 mm Hg; and pulse rate, 110 beats per minute. Prominent jugular pulsations ("v" waves) were noted. A grade 3/6 harsh systolic murmur was heard at the second left intercostal space. The rest . . . [Full Text PDF of this Article]

Author Affiliations
From the divisions of infectious diseases and immunology (Drs. Markowitz and Duma) and hematology (Dr. Stith), Department of Medicine (Drs. Rothkopf and Holden), Medical College of Virginia, Virginia Commonwealth University, Richmond.

Footnotes
Reprint requests to Division of Infectious Diseases and Immunology, Medical College of Virgina, Richmond, VA 23298 (Dr. Markowitz).

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