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A Case of Levamisole-Induced Agranulocytosis. 2018

Thamer Kassim, and Lakshmi Chintalacheruvu, and Osman Bhatty, and Mohammad Selim, and Osama Diab, and Ali Nayfeh, and Jayadev Manikkam Umakanthan, and Maryam Gbadamosi-Akindele
Department of Internal Medicine, Creighton University, Omaha, NE, USA.

A sixty-eight-year-old male with a past medical history of recurrent cocaine use presented to the emergency department with recurrent diarrhea and was found to have a white blood cell (WBC) count of 1.9 × 109/L with agranulocytosis (absolute neutrophil count (ANC) of 95 cell/mm3). At admission, the patient disclosed that he used cocaine earlier during the day, and a urine drug screen tested positive for this. On hospital day one, the patient was found to have a fever with a maximum temperature of 313.6 K. After ruling out other causes and noting the quick turnaround of his neutropenia after four days of cocaine abstinence, the patient's neutropenia was attributed to levamisole-adulterated cocaine.

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