Abstract

Objective: Piperacillin/tazobactam (TZP ) is commonly used against multi-resistant nosocomial Pseudomonas infections. While TZP-induced thrombocytopenia is a well-known and easily diagnosed complication, we herein present an unusual case of spontaneous TZP-induced bleeding caused by platelet dysfunction.
Case summary: A 73-year-old-man experienced severe pulmonary hemorrhage and bloody diarrhea during the treatment with TZP for Pseudomonas aeruginosa ventilator-associated pneumonia. While both platelet count and coagulation tests were normal, platelet functional test revealed severely impaired ADP-dependent platelet aggregation.
Conclusion: Platelet dysfunction is a little-known mechanism of TZP-induced bleeding. This is the second reported case of TZP-related bleeding that has been attributed to platelet dysfunction, and the first case report that has not been associated with surgery. While thrombocytopenia is easily recognized, this form of TZP-induced bleeding can be detected only by platelet functional tests.

Author Details

Authors

• Bosko Skoric^{1, 2}
• Antonio Agic²
• Marijan Pasalic^{1, 2}
• Jure Samardzic^{1, 2}
• Davor Milicic^{1, 2}

Departments

• ¹ Department of Cardiovascular Diseases, University Hospital Center Zagreb, and
• ² University of Zagreb School of Medicine, Zagreb, Croatia

Address


Bosko Skoric, MD, PhD
Department of Cardiovascular Diseases
University of Zagreb School of Medicine
University Hospital Center Zagreb
Kispaticeva 12, 10 000 Zagreb, Croatia
Email: [email protected]

Citation