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Drug-induced thrombocytopenia is a common cause of thrombocytopenia and a long list of drugs are implicated in this phenomenon. There are at least 3 mechanisms implicated in drug-induced thrombocytopenia; bone marrow suppression, immunological and non-immunological thrombocytopenia. We present here a case of a young adult female presenting with a perinephric abscess who was started on broad-spectrum piperacillin-tazobactam. On day 12 of the starting antibiotics there was an abrupt and thereafter rapid decline in her platelet count. After a thorough investigation to rule out other possible causes of thrombocytopenia, drug-induced thrombocytopenia as a possible etiology was suspected. Subsequently, the antibiotic was withheld after a discussion with the hospital hematologist and a blood picture repeated daily thereafter showed a rapid increase in platelet count once the offending agent was withdrawn. The patient thereafter was started on a different class of antibiotic and had a complete recovery and was discharged after a prolonged stay of 33 days.
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