We report on a 43-year-old woman who developed a fulminant thrombotic thrombocytopenic purpura (TTP) in the early course of an oral ciprofloxacin therapy. An acute bacterial meningo-encephalitis with disseminated intravascular coagulation was first suspected. She also presented with haemolytic anaemia and a severe thrombocytopenia. The lumbar puncture was delayed and only performed after platelets transfusions. CSF examination ruled out meningo-encephalitis. A diagnosis of TTP was made and she was given plasma exchanges. However, her neurological status worsened and the cranial CT revealed a subarachnoidal hemorrhage in left sylvian valley with diffuse oedema predominating in the left cerebral hemisphere and multiple ischemic lacunes. She died four days after admission.
Mouraux, A., Gille, M., Piéret, F., & Declercq, I. (2008). [Fulminant thrombotic thrombocytopenic purpura in the course of ciprofloxacin therapy]. Revue Neurologique, 158(11), 1115-1157. https://hdl.handle.net/2078.5/51577 (Original work published 2002)