• Ming-Gui Wang, Dan Wang, and Jian-Qing He.
• Department of Respiratory and Critical Care Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan Province, People's Republic of China.
• Medicine (Baltimore). 2018 Aug 1; 97 (34): e11997.

RationaleThrombocytopenia caused by linezolid (LZD) is common, with a reported prevalence as high as 11.8%. Platelets typically reach normal levels 7 days after LZD withdrawal. However, recurrent profound thrombocytopenia due to LZD usage and a persistent profound drop in platelet count after LZD withdrawal have not been reported.Patient ConcernsWe report a case of a 75-year-old woman, who presented with recurrent profound thrombocytopenia induced by LZD treatment for multidrug-resistant tuberculosis (MDR-TB).DiagnosesLaboratory data and symptoms during and after LZD usage and reusage indicated severe thrombocytopenia.InterventionsLZD was discontinued due to recurrent thrombocytopenia and the platelet count continued to drop for 9 days and returned to normal gradually 16 days after LZD withdrawal and supportive care including platelet transfusion.OutcomesThere was no recurrence of thrombocytopenia during 10 months of follow-up during treatment for MDR-TB with a regimen without LZD.LessonsRecurrent profound thrombocytopenia can happen after several doses of LZD rechallenging. Therefore, reuse of LZD should be avoided after recovery from severe thrombocytopenia due to LZD.

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