Fusidic acid induced acute immunologic thrombocytopenia

Fusidic acid is used in hospitals as second-line therapy for multidrug-resistant staphylococcal infections. We report the first fully documented case of fusidic acid induced thrombocytopenia, in a 48-year-old patient, The thrombocytopenia was abrupt and severe but resolved spontaneously 7d after drug withdrawal, The thrombocytopenia transiently relapsed 6d later, when fusidic acid was reintroduced. Haemorrhagic signs were observed, but no severe bleeding occurred, Platelet transfusions failed to increase the platelet count. We detected an IgG platelet antibody in the patient's serum, that specifically recognized platelet glycoprotein IIb/IIIa only in the presence of fusidic acid. Fusidic acid induced thrombocytopenia should be considered as a possible cause for the thrombocytopenia frequently seen in the intensive care setting.