Latamoxef-induced severe thrombocytopenia during the treatment of pulmonary infection: A case report

Table 1 Timeline of the treatment process

Time	Symptom	Platelet counts	Treatment
Day 1	Bloody sputum, scattered mottled, high-density shadows in both lungs	140000/μL	Latamoxef (dose: 2.0 g) intravenously Q12H
Day 9	Chills and fever to 38.2 ℃ (18:00)	44000/μL (8:00 am)	-
Day 10	Positive T SPOT-TB testing results	-	Added isoniazid tablets 0.3 g QD, rifampicin capsules 0.6 g QD
Day 11	Secondary pulmonary tuberculosis, cervical lymph node tuberculosis, and splenic tuberculosis were confirmed	-	Continued adding pyrazinamide 0.5 g TID, ethambutol 1.0 g QD
Day 12	Body temperature returned to normal but scattered purpura and ecchymosis appeared on his limbs and trunk's skin	7000/μL	Replaced rifampicin with levofloxacin; Added recombinant human thrombopoietin (15000 units/d), human immunoglobulin (20.0 g/d), 15 units platelets, and 5 mg dexamethasone
Day 13	Hemoptysis	44000/μL	Continued adding tranexamic acid sodium chloride (0.5 g/d), etamsylate (2.0 g/d) and spearhead agkistrodon hemocoagulase (2.0 U/d) for hemostasis
Day 15	Critical state	9000/μL	Discontinued latamoxef 2.0 g Q12H and added vitamin K1 (10 mg/d)
Day 16	-	57000/μL	Discontinued the human immunoglobulin injection and recombinant human thrombopoietin
Day 17	-	157000/μL	Discontinued vitamin K1 and dexamethasone
Day 23	-	255000/μL	-
Day 24	Discharged	-	Took isoniazid, ethambutol, pyrazinamide, and levofloxacin for tuberculosis treatment
The 1, 3, 5 wk, and 15-mo after discharge	-	Normal	Took isoniazid, ethambutol, pyrazinamide, and levofloxacin for tuberculosis treatment

Thrombocytopenia: Platelet count less than 100000/μL. Abnormal values are given in italic font.