Community-acquired Lobar Pneumonia in Medicine / Internal Medicine — 45yo Man | Infectious Diseases | SMLE Q#19036
SMLE Question #19036
Medicine / Internal Medicine
Infectious Diseases
Objective: OBJ-IM-ID-THROMBOCYTOPENIA-1
Last updated: March 2026
A 45-year-old man is admitted with community-acquired lobar pneumonia. He has 3 days of productive cough, pleuritic chest pain, and fever. Chest radiograph shows right lower-lobe consolidation. He is started on IV ceftriaxone plus azithromycin; he also receives paracetamol and tramadol for pain/fever. After 24 hours, his fever improves and he is hemodynamically stable.
Vital signs: T 37.6°C, BP 122/76 mmHg, HR 88/min, RR 18/min, SpO2 96% on room air.
Lab results (baseline on admission 24 h later):
- Platelets: 210 70 ^9/L
- Hemoglobin: 14.2 g/dL
- WBC: 13.8 ^9/L
- Creatinine: 0.9 mg/dL
- AST/ALT: 24/28 U/L
He has no petechiae or active bleeding. Which medication is the most likely cause of this acute thrombocytopenia and should be stopped?
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