Sometimes Treatment Kills: Ceftriaxone-induced Hemolytic Anemia in a Case of Pyogenic Meningitis

Abstract

Drug-induced immune hemolytic anemia (DIIHA) is a rare condition that is often misdiagnosed or not diagnosed promptly, even at specialized medical facilities. The leading causes of DIIHA are antibiotics, particularly second and third-generation cephalosporins, and platinum-based chemotherapy. While identifying the responsible drug and discontinuing it typically resolves the issue, fatalities may still occur in cases of progressive immune-mediated hemolysis and underlying medical conditions. This case involves an 80-year-old man receiving injectable broad-spectrum antibiotics, including ceftriaxone, for pyogenic meningitis, who experienced severe hemolytic anemia that ultimately led to intracranial hemorrhage and death.

Keywords

• ceftriaxone
• drug-induced immune hemolytic anemia
• immunohematology