Vancomycin-Induced Thrombocytopenia in a 35-Year-Old Female With Pneumonia: A Case Report

Vancomycin is one of the most empirically used antibiotics in severely ill patients in hospitalized settings. Vancomycin-induced thrombocytopenia (VITP) is a rare and potentially life-threatening complication that requires immediate recognition. Platelet destruction is largely immune-mediated and re...

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Bibliographic Details
Published inCurēus (Palo Alto, CA) Vol. 15; no. 9
Main Authors Gyabaah, Frederick, Trivedi, Bhavi, Prakash, Swathi, Petersen, Cyrena, Ikeler, Jordan, Dihowm, Fatma
Format Journal Article
LanguageEnglish
Published Palo Alto Cureus Inc 25.09.2023
Cureus
Subjects
Allergy/Immunology
Analgesics
Antibiotics
Antibodies
Anticoagulants
Anticonvulsants
Antiparasitic agents
Blood clots
Blood platelets
Case reports
Creatinine
Drug dosages
Epidemiology/Public Health
Glycoproteins
Health sciences
Internal Medicine
Laboratories
Medicine
Pneumonia
Purpura
Staphylococcus infections
Thrombocytopenia
United States > US
Texas
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Summary:Vancomycin is one of the most empirically used antibiotics in severely ill patients in hospitalized settings. Vancomycin-induced thrombocytopenia (VITP) is a rare and potentially life-threatening complication that requires immediate recognition. Platelet destruction is largely immune-mediated and results in a precipitous drop in the platelet count over a short period of time. Most cases of VITP are drug-dependent, as discontinuation of the offending agent frequently results in a timely return to baseline to pre-exposure platelet levels. Here, we present a case of severe vancomycin-induced thrombocytopenia in a 35-year-old female with a history of multiple comorbidities who presented with pneumonia. She was undergoing treatment with vancomycin and piperacillin-tazobactam and developed thrombocytopenia within 24 hours of hospitalization. The patient was on a loading dose of 1250 mg intravenous vancomycin every 24 hours and piperacillin-tazobactam 3.375 g intravenously every six hours for presumed community-acquired pneumonia. Her other medications included ondansetron, bupropion, sertraline, tamsulosin, pantoprazole, ergocalciferol, and insulin glargine. Additionally, the patient was placed on a prophylactic dose of enoxaparin while in-patient. The patient’s thrombocytopenia resolved with discontinuation of vancomycin. Clinicians should be well-informed about which medications can trigger thrombocytopenia whenever starting a medication in such cases.
ISSN:2168-8184
2168-8184
DOI:10.7759/cureus.45945