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Rare complication of ceftriaxone therapy: drug-induced thrombocytopenia (DITP)
  1. Aishwarya Sharma1,
  2. Devendranath Mannuru2,3,
  3. Abhishek Matta2,3 and
  4. Amit Kaushal3
  1. 1School of Medicine and Health Sciences, University of North Dakota, Grand Forks, North Dakota, USA
  2. 2Internal Medicine, School of Medicine and Health Sciences, University of North Dakota, Grand Forks, North Dakota, USA
  3. 3Internal Medicine, Sanford Medical Center Fargo, Fargo, North Dakota, USA
  1. Correspondence to Aishwarya Sharma; aishwaryasharma97{at}


A 62-year-old woman with a history of end-stage renal disease on haemodialysis, essential hypertension and type 2 diabetes mellitus was diagnosed with sepsis and placed on 600 mg oral linezolid every 12 hours and 1 g intravenous ceftriaxone every 24 hours. Blood cultures grew Streptococcus dysgalactiae, and she was switched to intravenous ceftriaxone 2 g daily. Platelet counts slowly trended down after starting ceftriaxone reaching 5 K/μL on day 12 of treatment. Ceftriaxone was discontinued and heparin-induced thrombocytopaenia was ruled out. She was switched to vancomycin and her platelet count improved. Given the temporal relationship between changing platelet counts and starting and discontinuing ceftriaxone, a diagnosis of drug-induced thrombocytopaenia was made.

  • haematology (drugs and medicines)
  • unwanted effects / adverse reactions
  • drugs: infectious diseases

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  • Contributors AS: preparation, analysis, drafting and review of manuscript; DM: conception and design, acquisition of data and review of manuscript. AM: analysis, drafting and and review of manuscript. AK: acquisition of data and review of manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.