Fusidic acid induced acute immunologic thrombocytopenia

• Published in: British journal of haematology Vol. 93; no. 2; p. 427
• Main Authors: El-Kassar, N, Kalfon, P, Fromont, P, Vezinet, C, Godeau, B, Duedari, N, Bierling, P
• Format: Journal Article
• Language: English
• Published: England 01-05-1996
• Subjects: Acute Disease; Anti-Bacterial Agents - adverse effects; Drug Resistance, Multiple; Fusidic Acid - adverse effects; Humans; Middle Aged; Thrombocytopenia - chemically induced
• ISSN: 0007-1048
• DOI: 10.1046/j.1365-2141.1996.5211064.x

Fusidic acid is used in hospitals as second-line therapy for multidrug-resistant staphylococcal infections. We report the first fully documented case of fusidic acid induced thrombocytopenia, in a 48-year-old patient. The thrombocytopenia was abrupt and severe but resolved spontaneously 7 d after drug withdrawal. The thrombocytopenia transiently relapsed 6 d later, when fusidic acid was reintroduced. Haemorrhagic signs were observed, but no severe bleeding occurred. Platelet transfusions failed to increase the platelet count. We detected an IgG platelet antibody in the patient's serum, that specifically recognized platelet glycoprotein IIb/IIIa only in the presence of fusidic acid. Fusidic acid induced thrombocytopenia should be considered as a possible cause for the thrombocytopenia frequently seen in the intensive care setting.