Published online Aug 6, 2022. doi: 10.12998/wjcc.v10.i22.7906
Peer-review started: October 13, 2021
First decision: January 11, 2022
Revised: January 24, 2022
Accepted: June 24, 2022
Article in press: June 24, 2022
Published online: August 6, 2022
Latamoxef shows excellent antibacterial activity against anaerobic bacteria such as Bacteroides fragilis. Reports of thrombocytopenic toxicity of latamoxef are limited. This report presents a case of severe thrombocytopenia possibly induced by latamoxef, an infrequent adverse drug reaction in a young patient with tuber
We reported a case of severe thrombocytopenia induced by latamoxef in a 28-year-old man with tuberculosis and Crohn's disease. On admission, the patient presented with a cough productive of bloody sputum, a chest computed tomogram suggested scattered mottled, high-density shadows in both lungs. Laboratory tests indicated a platelet count of 140000/μL. Considered a pulmonary bacterial infection, the patient received anti-infection therapy with latamoxef (dose: 2.0 g) intravenously Q12h. On the 9th day of treatment, the platelet count decreased to 44000/μL. On the 12th day, scattered purpura and ecchymosis appeared on the patient’s limbs and trunk, and the platelet count decreased to 9000/μL after latamoxef treatment for 15 d. Three days after discontinuation of latamoxef, the platelet count recovered to 157000/μL, and the area of scattered purpura and ecchymosis on the limbs and trunk decreased. The platelet counts remained in the normal range, and no thrombocytopenia was found at follow-up 15 mo after discharge.
For patients treated with latamoxef, platelet counts should be carefully followed, and caregivers should be vigilant for the appearance of scattered ecchymosis.
Core Tip: We described a case of severe thrombocytopenia likely induced by latamoxef, an infrequent adverse drug reaction in a young patient with tuberculosis and Crohn's disease. We followed the changes in platelet counts and the appearance of purpura during latamoxef treatment and after drug withdrawal and excluded other possible causes of thrombocytopenia. Our findings suggested that the patient's thrombocytopenia was caused by latamoxef. This is the first reported case of severe thrombocytopenia induced by latamoxef in a young Chinese patient to the best of our knowledge.