Meropenem-induced thrombocytopenia: a paediatric case

BMJ Case Rep. 2021 Sep 3;14(9):e243443. doi: 10.1136/bcr-2021-243443.

Abstract

Meropenem is a broad-spectrum carbapenem widely used to treat both Gram-positive and negative bacterial infections, including extended-spectrum beta-lactamase-producing microbes. We describe the occurrence of thrombocytopenia and hypersensitivity in a boy receiving intravenous meropenem for intra-abdominal sepsis secondary to perforated appendicitis. The patient developed a pruritic maculopapular rash with occasional petechiae, associated with severe thrombocytopenia, after 7 days of meropenem administration. Investigations for other causes of thrombocytopenia, including possible line sepsis, were unfruitful, and the thrombocytopenia did not resolve until cessation of meropenem. Drug-induced reactions should be considered in children receiving meropenem who present with a rash and thrombocytopenia.

Keywords: contraindications and precautions; drugs: infectious diseases; haematology (drugs and medicines); paediatrics (drugs and medicines).

Publication types

  • Case Reports

MeSH terms

  • Anti-Bacterial Agents / adverse effects
  • Bacterial Infections* / drug therapy
  • Child
  • Humans
  • Male
  • Meropenem / adverse effects
  • Thienamycins / adverse effects
  • Thrombocytopenia* / chemically induced
  • Thrombocytopenia* / drug therapy

Substances

  • Anti-Bacterial Agents
  • Thienamycins
  • Meropenem