linezolid induced pancytopenia in a patient of extensively drug-resistant pulmonary tuberculosis: an unusual outcome

Linezolid (Lnz) is the first oxazolidinones to be developed and introduced in clinical use. Its use is growing by day and day in the treatment of resistant pulmonary tuberculosis (TB). Lnz has been associated with adverse hematological effects, primarily thrombocytopenia. But pancytopenia is a very rare complication. Myelosuppression is a rare and a serious side effect of Lnz. Here, we present a case of extensively drug-resistant pulmonary TB, which was started on Lnz. Patient returned 1-month back with clinical presentation suggestive of pancytopenia which was confirmed on bone marrow aspiration and was attributed to the use of Lnz. Patient improved on stopping the Lnz and adding steroid for a short course. This case report emphasizes the importance of both the use of Lnz for well-defined indications and appropriate hematological monitoring during the course of treatment.