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Severe Ceftriaxone-induced Hemolysis Complicated by Diffuse Cerebral Ischemia in a Child With Sickle Cell Disease

Schuettpelz, Laura G. MD, PhD*; Behrens, Deanna MD; Goldsmith, Matthew I. MD; Druley, Todd E. MD, PhD*

Journal of Pediatric Hematology/Oncology: November 2009 - Volume 31 - Issue 11 - p 870-872
doi: 10.1097/MPH.0b013e3181b7eda2
Clinical and Laboratory Observations

Ceftriaxone-induced hemolytic anemia is a rare and often fatal phenomenon. We report here the case of a 6-year-old female with sickle cell disease who survived a brisk and profound hemolytic reaction, resulting in hemoglobin of 0.4 g/dL, after ceftriaxone infusion. Ongoing hemolysis was abrogated with aggressive supportive care, but the patient suffered extensive neurologic sequelae as a result of the event. Serologic testing confirmed the presence of ceftriaxone antibodies.

Divisions of *Hematology and Oncology

Critical Care Medicine, Department of Pediatrics, Washington University School of Medicine, St Louis, MO

Reprints: Laura G. Schuettpelz, MD, PhD, Division of Hematology and Oncology, Department of Pediatrics, Saint Louis Children's Hospital, Washington University School of Medicine, Box 8116, 660 South Euclid Avenue, St Louis, MO 63110 (e-mail:

Received for publication April 13, 2009

accepted July 10, 2009

© 2009 Lippincott Williams & Wilkins, Inc.