SHM Converge Scientific Abstract ePoster Gallery-Ceftriaxone Induced Life-Threatening Biocytopenia Inclingind Thrombocytopenia and Acute Anemia: Case Report and Literature Review

Ceftriaxone Induced Life-Threatening Biocytopenia Inclingind Thrombocytopenia and Acute Anemia: Case Report and Literature Review

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Pdf Summary

A 57-year-old man with multiple comorbidities developed a rapidly worsening petechial rash and bleeding gums shortly after treatment for an infected prosthetic knee joint. He had initially received vancomycin and piperacillin-tazobactam, but cultures grew <em>Pasteurella multocida</em>, so therapy was changed to ceftriaxone. About seven days later, he presented with extensive petechiae and severe cytopenias: WBC 17.64 × 10^9/L, hemoglobin 6.7 g/dL, and platelets 3 × 10^9/L. Reticulocyte count was elevated, bilirubin was normal, and antibody testing was positive for ceftriaxone IgG; flow cytometry detected reactivity only in the presence of ceftriaxone.

Ceftriaxone was stopped immediately. He was treated with platelet and packed red blood cell transfusions, IV methylprednisolone followed by dexamethasone, and one dose of IVIG. Over the next 10 days, his hemoglobin and platelet count returned to baseline.

The case was diagnosed as confirmed ceftriaxone-induced immune thrombocytopenia, a rare but potentially life-threatening adverse drug reaction. Unlike typical drug-induced thrombocytopenia, this patient also developed acute anemia without evidence of hemolysis or bleeding, suggesting ceftriaxone may have affected the red cell line through an unclear immune mechanism. The report highlights that clinicians should recognize even mild early platelet declines during ceftriaxone therapy and act quickly to prevent severe, life-threatening bicytopenia.

Asset Subtitle

Lihua Zou

Meta Tag

Author List Anil Singh, Jovanovic Mateja, Lihua Zou, Qi Shi, Siddhartha Yedla

Category Clinical Vignettes

Concept Ceftriaxone

Concept Drug-Induced Immune Thrombocytopenia

Concept Thrombocytopenia

Concept Drug Discontinuation

Concept Severe Thrombocytopenia

Distinguished Non-Finalist

Presenter Organization NE Geisinger IM

Presenting Author Lihua Zou

Track Adult

Keywords

ceftriaxone

immune thrombocytopenia

bicytopenia

petechial rash

bleeding gums

drug-induced cytopenia

Pasteurella multocida

platelet transfusion

IVIG

adverse drug reaction

Ceftriaxone

Drug-Induced Immune Thrombocytopenia

Thrombocytopenia

Drug Discontinuation

Severe Thrombocytopenia