Abstract: Objective To investigate a rare adverse reaction caused by zoledronic acid injection and provide a reference for safe and rational drug use in clinical practice. Methods The process of diagnosing and treating one case of agranulocytosis induced by zoledronic acid injection was analyzed. The clinical manifestations, risk factors, and prevention strategies related to this adverse reaction were summarized based on both domestic and foreign literature. Results After the administration of zoledronic acid injection, the patient developed persistent fever accompanied by sore throat. Three days later, a blood routine examination pointed to agranulocytosis. Following treatment with granulocyte colony-stimulating factors, the granulocyte count returned to normal while the associated symptoms, including fever and sore throat, were mitigated. Conclusion When zoledronic acid injection is used clinically, clinicians should be vigilant to the occurrence of agranulocytosis and ensure quick identification and treatment.

Key words: Zoledronic Acid Injection, Agranulocytosis, Fever, Sore Throat, Adverse Drug Reaction