Ciprofloxacin-Induced Thrombotic Thrombocytopenic Purpura: A Case of Successful Treatment and Review of the Literature

A 49-year-old African American woman was admitted to our hospital with abdominal pain, nausea, vomiting, lethargy, and confusion. She was receiving ciprofloxacin for a urinary-tract infection prior to admission. Laboratory examination revealed anemia, thrombocytopenia, elevated lactate dehydrogenase...

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Main Authors: Hafiz Rizwan Talib Hashmi, Gilda Diaz-Fuentes, Preeti Jadhav, Misbahuddin Khaja
Format: Article
Language:English
Published: Wiley 2015-01-01
Series:Case Reports in Critical Care
Online Access:http://dx.doi.org/10.1155/2015/143832
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author Hafiz Rizwan Talib Hashmi
Gilda Diaz-Fuentes
Preeti Jadhav
Misbahuddin Khaja
author_facet Hafiz Rizwan Talib Hashmi
Gilda Diaz-Fuentes
Preeti Jadhav
Misbahuddin Khaja
author_sort Hafiz Rizwan Talib Hashmi
collection DOAJ
description A 49-year-old African American woman was admitted to our hospital with abdominal pain, nausea, vomiting, lethargy, and confusion. She was receiving ciprofloxacin for a urinary-tract infection prior to admission. Laboratory examination revealed anemia, thrombocytopenia, elevated lactate dehydrogenase, and serum creatinine. Peripheral smear showed numerous schistocytes, and the patient was diagnosed with thrombotic thrombocytopenic purpura (TTP). Ciprofloxacin was identified as the offending agent. The patient received treatment with steroids and plasmapheresis, which led to rapid clinical recovery. This is the first case to our knowledge of successfully treated ciprofloxacin-induced TTP; previously reported cases had fulminant outcomes. Quinolones are an important part of the antibiotic armamentarium, and this case can raise awareness of the association between quinolones and TTP. A high index of suspicion for detection and early and aggressive management are vitally important for a successful outcome.
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series Case Reports in Critical Care
spelling doaj-art-ba027ccc64494bd4a57f9574e9d901c32025-08-20T02:19:26ZengWileyCase Reports in Critical Care2090-64202090-64392015-01-01201510.1155/2015/143832143832Ciprofloxacin-Induced Thrombotic Thrombocytopenic Purpura: A Case of Successful Treatment and Review of the LiteratureHafiz Rizwan Talib Hashmi0Gilda Diaz-Fuentes1Preeti Jadhav2Misbahuddin Khaja3Division of Pulmonary and Critical Care Medicine, Bronx Lebanon Hospital Center, Bronx, NY 10457, USADivision of Pulmonary and Critical Care Medicine, Bronx Lebanon Hospital Center, Bronx, NY 10457, USADepartment of Internal Medicine, Bronx Lebanon Hospital Center, Albert Einstein College of Medicine, Bronx, NY 10457, USADivision of Pulmonary and Critical Care Medicine, Bronx Lebanon Hospital Center, Bronx, NY 10457, USAA 49-year-old African American woman was admitted to our hospital with abdominal pain, nausea, vomiting, lethargy, and confusion. She was receiving ciprofloxacin for a urinary-tract infection prior to admission. Laboratory examination revealed anemia, thrombocytopenia, elevated lactate dehydrogenase, and serum creatinine. Peripheral smear showed numerous schistocytes, and the patient was diagnosed with thrombotic thrombocytopenic purpura (TTP). Ciprofloxacin was identified as the offending agent. The patient received treatment with steroids and plasmapheresis, which led to rapid clinical recovery. This is the first case to our knowledge of successfully treated ciprofloxacin-induced TTP; previously reported cases had fulminant outcomes. Quinolones are an important part of the antibiotic armamentarium, and this case can raise awareness of the association between quinolones and TTP. A high index of suspicion for detection and early and aggressive management are vitally important for a successful outcome.http://dx.doi.org/10.1155/2015/143832
spellingShingle Hafiz Rizwan Talib Hashmi
Gilda Diaz-Fuentes
Preeti Jadhav
Misbahuddin Khaja
Ciprofloxacin-Induced Thrombotic Thrombocytopenic Purpura: A Case of Successful Treatment and Review of the Literature
Case Reports in Critical Care
title Ciprofloxacin-Induced Thrombotic Thrombocytopenic Purpura: A Case of Successful Treatment and Review of the Literature
title_full Ciprofloxacin-Induced Thrombotic Thrombocytopenic Purpura: A Case of Successful Treatment and Review of the Literature
title_fullStr Ciprofloxacin-Induced Thrombotic Thrombocytopenic Purpura: A Case of Successful Treatment and Review of the Literature
title_full_unstemmed Ciprofloxacin-Induced Thrombotic Thrombocytopenic Purpura: A Case of Successful Treatment and Review of the Literature
title_short Ciprofloxacin-Induced Thrombotic Thrombocytopenic Purpura: A Case of Successful Treatment and Review of the Literature
title_sort ciprofloxacin induced thrombotic thrombocytopenic purpura a case of successful treatment and review of the literature
url http://dx.doi.org/10.1155/2015/143832
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