International Journal of Infectious Diseases and Therapy

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Ciprofloxacin-Induced Thrombocytopenia: A Case Report and Literature Review

Received: 27 July 2023    Accepted: 24 August 2023    Published: 13 September 2023
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Abstract

Background: Drug induced thrombocytopenia is associated with several usual drugs. It usually presents with stunning, chills, fever, nausea and vomiting followed by the occurrence of petechial hemorrhages and bruising. Fluoroquinolones which are a widely used antibiotics are not recognized to be common offenders. Ciprofloxacin is generally considered a safe and well-tolerated drug. It has a large spectrum and it is one of the most widely prescribed antibiotics in a broad range of infections. Purpose: Only a few cases of fluoroquinolone-induced thrombocytopenia have been reported thus this side effect is largely unknown by clinicians. Case: We report the case of a 55 year old women with a bilateral percutaneous nephrostomy secondary to a radiation-induced cystitis. She was known for chronic kidney disease KDIGO IIIb and arterial hypertension. She suffered severe thrombocytopenia on three different occasions while treated by ciprofloxacin for urinary infections. She remained asymptomatic although her platelet count dropped as low as 6×103/µL. Each time, her platelet count recovered within a few days after ciprofloxacin interruption. Conclusion: Clinicians should be aware of the possible relationship between thrombocytopenia and ciprofloxacin. In depth work-up should be carried out to assess relationship between a newly introduced drug and a serious clinical or biological side effect.

DOI 10.11648/j.ijidt.20230803.17
Published in International Journal of Infectious Diseases and Therapy (Volume 8, Issue 3, September 2023)
Page(s) 122-126
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2024. Published by Science Publishing Group

Keywords

Ciprofloxacin, Thrombocytopenia, Drug Induced Toxicity, Antibiotic Toxicity, Hematologic Toxicity

References
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[5] Williamson DR, Lesur O, Tetrault JP, Pilon D. Drug-induced thrombo-cytopenia in the critically ill: a case-control study. Ann Pharmacother. 2014; 48: 697-704.
[6] Hashmi HR, Diaz-Fuentes G, Jadhav P, Khaja M. Ciprofloxacin-Induced Thrombotic Thrombocytopenic Purpura: A Case of Successful Treatment and Review of the Literature. Case Rep Crit Care. 2015; 2015: 143832. doi: 10.1155/2015/143832. Epub 2015 Oct 26. PMID: 26587293; PMCID: PMC4637463.
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  • APA Style

    Alexis Orman, Mohamed Tayeb Salaouatchi, Anne Demulder, Juliette Coryn, Victor Fernando Calderon Plazarte, et al. (2023). Ciprofloxacin-Induced Thrombocytopenia: A Case Report and Literature Review. International Journal of Infectious Diseases and Therapy, 8(3), 122-126. https://doi.org/10.11648/j.ijidt.20230803.17

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    ACS Style

    Alexis Orman; Mohamed Tayeb Salaouatchi; Anne Demulder; Juliette Coryn; Victor Fernando Calderon Plazarte, et al. Ciprofloxacin-Induced Thrombocytopenia: A Case Report and Literature Review. Int. J. Infect. Dis. Ther. 2023, 8(3), 122-126. doi: 10.11648/j.ijidt.20230803.17

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    AMA Style

    Alexis Orman, Mohamed Tayeb Salaouatchi, Anne Demulder, Juliette Coryn, Victor Fernando Calderon Plazarte, et al. Ciprofloxacin-Induced Thrombocytopenia: A Case Report and Literature Review. Int J Infect Dis Ther. 2023;8(3):122-126. doi: 10.11648/j.ijidt.20230803.17

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  • @article{10.11648/j.ijidt.20230803.17,
      author = {Alexis Orman and Mohamed Tayeb Salaouatchi and Anne Demulder and Juliette Coryn and Victor Fernando Calderon Plazarte and André Efira and Philippe Clevenbergh},
      title = {Ciprofloxacin-Induced Thrombocytopenia: A Case Report and Literature Review},
      journal = {International Journal of Infectious Diseases and Therapy},
      volume = {8},
      number = {3},
      pages = {122-126},
      doi = {10.11648/j.ijidt.20230803.17},
      url = {https://doi.org/10.11648/j.ijidt.20230803.17},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ijidt.20230803.17},
      abstract = {Background: Drug induced thrombocytopenia is associated with several usual drugs. It usually presents with stunning, chills, fever, nausea and vomiting followed by the occurrence of petechial hemorrhages and bruising. Fluoroquinolones which are a widely used antibiotics are not recognized to be common offenders. Ciprofloxacin is generally considered a safe and well-tolerated drug. It has a large spectrum and it is one of the most widely prescribed antibiotics in a broad range of infections. Purpose: Only a few cases of fluoroquinolone-induced thrombocytopenia have been reported thus this side effect is largely unknown by clinicians. Case: We report the case of a 55 year old women with a bilateral percutaneous nephrostomy secondary to a radiation-induced cystitis. She was known for chronic kidney disease KDIGO IIIb and arterial hypertension. She suffered severe thrombocytopenia on three different occasions while treated by ciprofloxacin for urinary infections. She remained asymptomatic although her platelet count dropped as low as 6×103/µL. Each time, her platelet count recovered within a few days after ciprofloxacin interruption. Conclusion: Clinicians should be aware of the possible relationship between thrombocytopenia and ciprofloxacin. In depth work-up should be carried out to assess relationship between a newly introduced drug and a serious clinical or biological side effect.},
     year = {2023}
    }
    

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    AU  - Alexis Orman
    AU  - Mohamed Tayeb Salaouatchi
    AU  - Anne Demulder
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    JO  - International Journal of Infectious Diseases and Therapy
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    PB  - Science Publishing Group
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    AB  - Background: Drug induced thrombocytopenia is associated with several usual drugs. It usually presents with stunning, chills, fever, nausea and vomiting followed by the occurrence of petechial hemorrhages and bruising. Fluoroquinolones which are a widely used antibiotics are not recognized to be common offenders. Ciprofloxacin is generally considered a safe and well-tolerated drug. It has a large spectrum and it is one of the most widely prescribed antibiotics in a broad range of infections. Purpose: Only a few cases of fluoroquinolone-induced thrombocytopenia have been reported thus this side effect is largely unknown by clinicians. Case: We report the case of a 55 year old women with a bilateral percutaneous nephrostomy secondary to a radiation-induced cystitis. She was known for chronic kidney disease KDIGO IIIb and arterial hypertension. She suffered severe thrombocytopenia on three different occasions while treated by ciprofloxacin for urinary infections. She remained asymptomatic although her platelet count dropped as low as 6×103/µL. Each time, her platelet count recovered within a few days after ciprofloxacin interruption. Conclusion: Clinicians should be aware of the possible relationship between thrombocytopenia and ciprofloxacin. In depth work-up should be carried out to assess relationship between a newly introduced drug and a serious clinical or biological side effect.
    VL  - 8
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Author Information
  • Internal Medicine Department, University Hospital Brugmann, Université Libre de Bruxelles (ULB), Brussels, Belgium

  • Internal Medicine Department, University Hospital Brugmann, Université Libre de Bruxelles (ULB), Brussels, Belgium

  • Hematology Laboratory, Universitary Laboratorium Brussel (LHUB-ULB), University Hospital Brugmann, Brussels, Belgium

  • Internal Medicine Department, University Hospital Brugmann, Université Libre de Bruxelles (ULB), Brussels, Belgium

  • Urology Clinic, University Hospital Brugmann, Université Libre de Bruxelles (ULB), Brussels, Belgium

  • Hematology Oncology Clinic, University Hospital Brugmann, Université Libre de Bruxelles (ULB), Brussels, Belgium

  • Infectious Diseases Clinic, University Hospital Brugmann, Université Libre de Bruxelles (ULB), Brussels, Belgium

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