Cefazolin-induced hemolytic anemia: a case report and systematic review of literature

Abstract Background Cefazolin is a first-generation cephalosporin commonly used for skin and soft tissue infections, abdominal and orthopedic surgery prophylaxis, and methicillin-sensitive staph aureus. Cephalosporins as a whole are known potential inducers of hemolytic anemia; however, mechanism of...

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Autores principales:	Elizabeth Mause, Mohammad Selim, Manasa Velagapudi
Formato:	article
Lenguaje:	EN
Publicado:	BMC 2021
Materias:	Cefazolin Hemolytic anemia Adverse drug reaction Cefazolin allergy Hemolysis Eosinophilia Medicine R
Acceso en línea:	https://doaj.org/article/db5d21afb8a14fbf98ade540d66021c3
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spelling	oai:doaj.org-article:db5d21afb8a14fbf98ade540d66021c32021-11-28T12:23:40ZCefazolin-induced hemolytic anemia: a case report and systematic review of literature10.1186/s40001-021-00604-92047-783Xhttps://doaj.org/article/db5d21afb8a14fbf98ade540d66021c32021-11-01T00:00:00Zhttps://doi.org/10.1186/s40001-021-00604-9https://doaj.org/toc/2047-783XAbstract Background Cefazolin is a first-generation cephalosporin commonly used for skin and soft tissue infections, abdominal and orthopedic surgery prophylaxis, and methicillin-sensitive staph aureus. Cephalosporins as a whole are known potential inducers of hemolytic anemia; however, mechanism of action is primarily autoimmune, and compared to other drugs, cefazolin is the least common. Methods A rare case report of cefazolin-induced hemolytic anemia “CIHA” and a systematic review of CIHA articles in English literature. Two authors performed review of publications and articles were selected based on inclusion and exclusion criteria. A systematic search of the literature yielded 768 entries with five case reports on cefazolin-induced hemolytic anemia. Case presentation/results An 80-year-old female with methicillin-sensitive Staphylococcus aureus “MSSA” endocarditis. The patient was started on intravenous “IV” cefazolin that that resulted in hemolytic anemia and eosinophilia. Switching to vancomycin improved hemoglobin level and resolved eosinophilia. Four cefazolin-induced hemolytic anemia case reports and one population-based article with a case reported were analyzed with respect to direct antiglobulin test “DAT” (also known as the direct Coombs test) results, prior penicillin sensitivity, and acute anemia causes exclusion. Conclusions CIHA is a rare cause of clinically significant anemia. The diagnosis of drug-induced anemia is one of exclusion. It is important to consider DAT results and prior penicillin sensitivity when evaluating a patient for cefazolin-induced hemolytic anemia. However, the frequency of cefazolin use and resultant anemia necessitates early recognition of hemolytic anemia and prompt discontinuation of cefazolin, especially with long-term use.Elizabeth MauseMohammad SelimManasa VelagapudiBMCarticleCefazolinHemolytic anemiaAdverse drug reactionCefazolin allergyHemolysisEosinophiliaMedicineRENEuropean Journal of Medical Research, Vol 26, Iss 1, Pp 1-6 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Cefazolin Hemolytic anemia Adverse drug reaction Cefazolin allergy Hemolysis Eosinophilia Medicine R
spellingShingle	Cefazolin Hemolytic anemia Adverse drug reaction Cefazolin allergy Hemolysis Eosinophilia Medicine R Elizabeth Mause Mohammad Selim Manasa Velagapudi Cefazolin-induced hemolytic anemia: a case report and systematic review of literature
description	Abstract Background Cefazolin is a first-generation cephalosporin commonly used for skin and soft tissue infections, abdominal and orthopedic surgery prophylaxis, and methicillin-sensitive staph aureus. Cephalosporins as a whole are known potential inducers of hemolytic anemia; however, mechanism of action is primarily autoimmune, and compared to other drugs, cefazolin is the least common. Methods A rare case report of cefazolin-induced hemolytic anemia “CIHA” and a systematic review of CIHA articles in English literature. Two authors performed review of publications and articles were selected based on inclusion and exclusion criteria. A systematic search of the literature yielded 768 entries with five case reports on cefazolin-induced hemolytic anemia. Case presentation/results An 80-year-old female with methicillin-sensitive Staphylococcus aureus “MSSA” endocarditis. The patient was started on intravenous “IV” cefazolin that that resulted in hemolytic anemia and eosinophilia. Switching to vancomycin improved hemoglobin level and resolved eosinophilia. Four cefazolin-induced hemolytic anemia case reports and one population-based article with a case reported were analyzed with respect to direct antiglobulin test “DAT” (also known as the direct Coombs test) results, prior penicillin sensitivity, and acute anemia causes exclusion. Conclusions CIHA is a rare cause of clinically significant anemia. The diagnosis of drug-induced anemia is one of exclusion. It is important to consider DAT results and prior penicillin sensitivity when evaluating a patient for cefazolin-induced hemolytic anemia. However, the frequency of cefazolin use and resultant anemia necessitates early recognition of hemolytic anemia and prompt discontinuation of cefazolin, especially with long-term use.
format	article
author	Elizabeth Mause Mohammad Selim Manasa Velagapudi
author_facet	Elizabeth Mause Mohammad Selim Manasa Velagapudi
author_sort	Elizabeth Mause
title	Cefazolin-induced hemolytic anemia: a case report and systematic review of literature
title_short	Cefazolin-induced hemolytic anemia: a case report and systematic review of literature
title_full	Cefazolin-induced hemolytic anemia: a case report and systematic review of literature
title_fullStr	Cefazolin-induced hemolytic anemia: a case report and systematic review of literature
title_full_unstemmed	Cefazolin-induced hemolytic anemia: a case report and systematic review of literature
title_sort	cefazolin-induced hemolytic anemia: a case report and systematic review of literature
publisher	BMC
publishDate	2021
url	https://doaj.org/article/db5d21afb8a14fbf98ade540d66021c3
work_keys_str_mv	AT elizabethmause cefazolininducedhemolyticanemiaacasereportandsystematicreviewofliterature AT mohammadselim cefazolininducedhemolyticanemiaacasereportandsystematicreviewofliterature AT manasavelagapudi cefazolininducedhemolyticanemiaacasereportandsystematicreviewofliterature
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Cefazolin-induced hemolytic anemia: a case report and systematic review of literature

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