We describe a patient admitted to the intensive care unit following a
penetrating head injury. This patient developed agranulocytosis and su
bsequently pancytopenia secondary to an idiosyncratic drug reaction. T
he possible causative drugs are phenytoin, cloxacillin, ceftriaxone an
d ceftazidime. The patient was treated with recombinant human granuloc
yte colony-stimulating factor.