Antibiotic-Associated Leukocytosis and Thrombocytosis: An Intriguing Paradoxical Condition
Abstract
Antibiotics are indispensable for the treatment of bacterial infections. In such infections, leukocytosis and thrombocytosis are commonly observed. With appropriate antibiotic treatment, white blood cell (WBC) and platelet (PLT) counts are expected to normalize. However, rarely, antibiotic therapy itself may lead to leukocytosis and thrombocytosis. We report a case of antibiotic-associated leukocytosis and thrombocytosis in a 29-year-old woman hospitalized for urinary tract infection (UTI) and pneumonia. Leukocytosis and thrombocytosis developed during treatment with meropenem and moxifloxacin. No alternative explanation could be identified through diagnostic evaluations. WBC and PLT counts returned to normal after discontinuation of meropenem and moxifloxacin. To the best of our knowledge, leukocytosis associated with meropenem and moxifloxacin has not been previously reported. Thrombocytosis related to meropenem has only rarely been documented. It is important to consider that treatment with meropenem and moxifloxacin may induce leukocytosis and thrombocytosis in patients.
Keywords
Ethical Statement
References
- 1. Urakami T, Matono T. Management of antibiotic adverse events. J Infect Chemother. 2025;31(7):102735. doi:10.1016/j.jiac.2025.102735.
- 2. Viner E, Berger J, Bengualid V. Etiologies of extreme leukocytosis. Cureus. 2023;15(4):e38062. doi:10.7759/ cureus.38062.
- 3. Almanaseer A, Chin-Yee B, Ho J, Lazo-Langner A, Schenkel L, Bhai P, et al. An approach to the investigation of thrombocytosis: differentiating between essential thrombocythemia and secondary thrombocytosis. Adv Hematol. 2024;2024(1):3056216. doi:10.1155/2024/3056216.
- 4. Altyar AE, Kamran SH, Batool H, Saleem Z, Shahid N. Investigating thrombocytopenia in meropenem-treated patients: a cross-sectional observational study. Futur J Pharm Sci. 2025;11:98. doi:10.1186/s43094-025-00858-8.
- 5. Chang X, Han L, Liu Y, Fan Z, Wu J. Analysis of adverse drug reactions caused by carbapenems and review of related literature. Journal of Chinese Pharmaceutical Sciences. 2023;32(10):835-41.
- 6. Koul AN, Sheikh JA, Pervaiz AK. Moxifloxacin-associated neutropenia. Scandinavian Journal of Infectious Diseases. 2013;45(10):809–10. doi:10.3109/00365548.2013.810816.
- 7. Coker TJ. Drug-induced immune thrombocytopenia due to moxifloxacin. BMJ Case Rep. 2013;2013:bcr2012007501. doi:10.1136/bcr-2012-007501.
- 8. Sun C, Zhao L, Yuan Y, Xiang Y, Liu A. Detection of drug safety signal of drug-induced neutropenia and agranulocytosis in all-aged patients using electronic medical records. Pharmacoepidemiol Drug Saf. 2023;32(4):416-25. doi:10.1002/pds.5559.
Details
Primary Language
English
Subjects
Infectious Diseases , Internal Diseases
Journal Section
Case Report
Authors
Caner Öksüz
*
0000-0002-3944-4608
Türkiye
Publication Date
February 26, 2026
Submission Date
January 5, 2026
Acceptance Date
January 27, 2026
Published in Issue
Year 2026 Volume: 8