Adverse Drug Reaction Assessment: Pancytopenia: which to blame? Tazocin, Omeprazole, Metronidazole or Enoxaparin

A 42-year-old female weighing 75 Kg was admitted to the ICU on 24/5/2009 with septic wound following hysterectomy, septicemia complicated by hypokalemia (2.4 mEq/L), hypomagnesaemia and hypocalcemia (6.1 mg/dL), fever (38 °C) and tachycardia (120 bpm). The patient was HCV positive, had cirrhotic liver with spleenomegaly (modified Child-Pugh class A) and Type I DM. On admission, her CBC revealed HB: 8 gm%, platelets: 131x10³/mm³, WBCs: 4.2x10³/mm³. The patient did not receive blood or platelet transfusion and serum billirubin was within normal range throughout the period of admission (1-1.3 mg/dL).