Rifampicin-induced thrombocytopenia

The discovery of rifampicin in 1965 ushered in the era of short-course antituberculosis (TB) chemotherapy. The duration of anti-TB therapy was reduced from 12–24 months to 6 months. Thrombocytopenia is an uncommon but severe side effect of rifampicin, which needs a high clinical index of suspicion for diagnosis. It reverses completely on stopping the drug. Re-challenge is not advised because thrombocytopenia will recur on re-initiation of the drug. We present the case of a patient with rifampicin-induced thrombocytopenia who presented with purpuric rash all over the body. Investigations revealed a low platelet count which resolved completely on stopping the drug. This case highlights the importance of diagnosis of a rare adverse drug reaction and prompts management, which leads to a good outcome.