case_images: PMC9218361_01
case_images: Changes in platelets during treatment.   means vancomycin exposure,   means discontinuation of vancomycin. PLT, platelet; U, unit, 1U = 2.5 x 1011 platelets.
case_images: fmed-09-829267-g0001.jpg
case_images: PMC9218361_01_fmed-09-829267-g0001.jpg
case_images: F1
case_images: Unexpectedly, his platelet count (7 x 109/L) severely decreased on D4 (Figure 1).
case_images: Diagnostic reasoning in thrombocytopenia. APS, antiphospholipid syndrome; DIC, disseminated intravascular coagulation; DITP, drug-induced thrombocytopenia; ITP, immune thrombocytopenia; HIT, heparin-induced thrombocytopenia; MDS, myelodysplastic syndrome; TMA, thrombotic microangiopathy.
case_images: fmed-09-829267-g0002.jpg
case_images: PMC9218361_01_fmed-09-829267-g0002.jpg
case_images: F2
case_images: To find the causes of thrombocytopenia, as Figure 2 shows, firstly, we excluded the possibility of laboratory error or pseudothrombocytopenia by examining the peripheral blood smear for platelet clumping and repeating the platelet count test. Thus, vancomycin was discontinued on D5 in the morning (the overall diagnostic diagram is shown in Figure 2), and a platelet transfusion (1U) was given to prevent hemorrhage.