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Isolated severe thrombocytopenia and bleeding caused by piperacillin
E Olivera1, P Lakhani, C Watanakunakorn
1Department of Internal Medicine, St. Elizabeth Hospital Medical Center, Youngstown, Ohio 44501-1790.
Scandinavian Journal of Infectious Diseases
|January 1, 1992
Summary
Piperacillin can cause severe thrombocytopenia, a condition of low platelets, leading to bleeding. This drug-induced immune reaction necessitates careful monitoring of platelet counts during treatment.
Area of Science:
- Pharmacology
- Hematology
- Infectious Diseases
Background:
- Piperacillin is a broad-spectrum antibiotic commonly used for serious bacterial infections.
- Pseudomonas aeruginosa septicemia is a life-threatening condition requiring aggressive antibiotic therapy.
Observation:
- A 71-year-old male patient developed severe thrombocytopenia and bleeding during piperacillin treatment for Pseudomonas aeruginosa septicemia.
- Platelet counts normalized after piperacillin discontinuation.
Findings:
- Piperacillin administration was directly linked to the onset of thrombocytopenia.
- Rechallenge with piperacillin confirmed a rapid recurrence of severe thrombocytopenia, indicating a drug-induced immune-mediated mechanism.
Implications:
- This case highlights the potential for piperacillin to cause severe, immune-mediated thrombocytopenia.
- Clinicians should consider piperacillin-induced thrombocytopenia in patients presenting with unexplained bleeding and low platelet counts during treatment.
- Close monitoring of platelet counts is crucial for patients receiving prolonged courses of piperacillin.