Hemolytic anemia as a result of piperacillin/tazobactam administration: a case report and discussion of pathophysiology

We report a case of a 19-year-old woman with cystic fibrosis who presented with hemolytic anemia during a course of piperacillin/tazobactam. The patient was initially managed with the replacement of blood products; however, she continued to show signs of hemolysis. Laboratories were obtained confirm...

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Bibliographic Details
Published in:Military medicine 2013-09, Vol.178 (9), p.e1045-e1047
Main Authors: Zanetti, Richard C, Biswas, Abhik K
Format: Article
Language:English
Subjects:
Adult
Anemia
Anemia, Hemolytic - chemically induced
Anemia, Hemolytic - drug therapy
Anti-Bacterial Agents - adverse effects
Antibiotics
Antibodies
Antigens
Blood products
Case reports
Cystic fibrosis
Drug dosages
Emergency medical care
Female
Hemoglobin
Humans
Immunoglobulins
Immunoglobulins, Intravenous - therapeutic use
Immunologic Factors - therapeutic use
Laboratories
Penicillanic Acid - adverse effects
Penicillanic Acid - analogs & derivatives
Piperacillin - adverse effects
Staphylococcus infections
Steroids
Young Adult
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Summary:We report a case of a 19-year-old woman with cystic fibrosis who presented with hemolytic anemia during a course of piperacillin/tazobactam. The patient was initially managed with the replacement of blood products; however, she continued to show signs of hemolysis. Laboratories were obtained confirming antibody formation to piperacillin/tazobactam, and she was given a single infusion of intravenous immunoglobulin. Following the infusion, the patient did not require administration of any further blood products and achieved stable red blood cell counts. Early recognition of hemolytic anemia secondary to piperacillin/tazobactam with the administration of intravenous immunoglobulin may shorten the duration of hospitalization and quantity of blood products required for the stabilization of red blood cell counts.
ISSN:0026-4075
1930-613X
DOI:10.7205/MILMED-D-12-00512