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VOL. 1, ISSUE 1 (2025)
A case report of Ceftriaxone-induced intravascular hemolysis leading to multi-organ failure
Authors
Haya H Ezadeen
Abstract
Ceftriaxone, a third-generation cephalosporin, is
widely prescribed due to its broad-spectrum activity and favorable safety
profile. However, rare but life-threatening adverse reactions such as
drug-induced immune hemolytic anemia (DIIHA) can occur, sometimes progressing
to intravascular hemolysis and multi-organ failure. We present the case of a
[age]-year-old [sex] who developed severe intravascular hemolysis within hours
of receiving intravenous ceftriaxone for [indication]. The patient rapidly
deteriorated, manifesting acute anemia, jaundice, hemoglobinuria, acute kidney
injury, and cardiovascular instability requiring intensive support. Laboratory
evaluation revealed severe hemolysis with elevated lactate dehydrogenase,
indirect hyperbilirubinemia, undetectable haptoglobin, and positive direct
antiglobulin test consistent with immune-mediated hemolysis. Despite aggressive
supportive care, including blood transfusions, corticosteroids, renal
replacement therapy, and vasopressors, the patient developed progressive
multi-organ failure. Ceftriaxone was immediately discontinued, and alternative
antimicrobial therapy was initiated. This case underscores the importance of
early recognition of ceftriaxone-induced hemolysis, a rare but often
catastrophic complication. Clinicians should maintain a high index of suspicion
for DIIHA in patients receiving cephalosporins who present with sudden anemia
and hemolysis, as timely drug withdrawal is the cornerstone of management.
Improved awareness and reporting of such cases are essential for early
diagnosis, patient safety, and prevention of recurrence.
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Pages:23-27
How to cite this article:
Haya H Ezadeen "A case report of Ceftriaxone-induced intravascular hemolysis leading to multi-organ failure". World Journal of Medical and Health, Vol 1, Issue 1, 2025, Pages 23-27
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