# Ciprofloxacin and Metronidazole As Rare Culprits of Drug-Induced Immune Thrombocytopenia in the Setting of Diverticulitis Treatment

## TL;DR

A 61-year-old woman developed a rare blood disorder after taking ciprofloxacin and metronidazole, which are not typically linked to this condition.

## Contribution

Reports a rare case linking ciprofloxacin and metronidazole to drug-induced immune thrombocytopenia.

## Key findings

- Thrombocytopenia occurred within 24 hours of starting ciprofloxacin and metronidazole.
- Platelet count normalized after discontinuing the antibiotics.
- Highlights the need to consider rare drug associations in thrombocytopenia diagnosis.

## Abstract

Drug-induced immune thrombocytopenia (DITP) is a syndrome in which antibodies bind to platelets only in the presence of a drug, leading to platelet destruction. A variety of medications, herbs, vaccines, and foods have been commonly associated with DITP. Here, we present a case of DITP in a 61-year-old female who was receiving two widely prescribed antibiotics, ciprofloxacin and metronidazole, which are not commonly linked to DITP. The patient developed thrombocytopenia within 24 hours of initiating these antibiotics, and her platelet count rapidly normalized following discontinuation of the drugs. Severe thrombocytopenia can lead to life-threatening bleeding; therefore, it is imperative that treating providers rule out alternative causes of thrombocytopenia and promptly discontinue any potential offending agents.