{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,28]],"date-time":"2025-11-28T12:35:44Z","timestamp":1764333344028,"version":"3.44.0"},"reference-count":17,"publisher":"BMJ","issue":"12","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2023,11,29]]},"published-print":{"date-parts":[[2023,12]]},"abstract":"<jats:p>Cefiderocol is a novel siderophore cephalosporin antibiotic. In the present case report, a woman in her 70s presented with a 1-week history of altered mental status and progressive purulent discharge from a non-healing diabetic foot ulcer on her right heel. MRI of the right foot revealed chronic osteomyelitis of the calcaneum. Surgical debridement was performed, and the tissue cultures grew extensively drug resistant (XDR) <jats:italic>Pseudomonas aeruginosa<\/jats:italic>, XDR <jats:italic>Acinetobacter baumannii<\/jats:italic> and <jats:italic>Enterococcus faecalis<\/jats:italic>. The patient received ampicillin-sulbactam and cefiderocol. The antibiotic treatment course was complicated by brown urine discolouration. Investigations were unrevealing for haemoglobinuria, myoglobinuria and bilirubinuria. A side effect from cefiderocol was suspected and subsequently discontinued. Her urine colour returned to its normal colour within 3 days of discontinuation of cefiderocol.<\/jats:p>","DOI":"10.1136\/bcr-2023-258207","type":"journal-article","created":{"date-parts":[[2023,12,16]],"date-time":"2023-12-16T11:45:40Z","timestamp":1702727140000},"page":"e258207","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":4,"title":["Cefiderocol-associated brown chromaturia"],"prefix":"10.1136","volume":"16","author":[{"given":"Michael","family":"Smith","sequence":"first","affiliation":[{"name":"Tufts Medical Center, Boston, Massachusetts, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6259-0032","authenticated-orcid":false,"given":"Kap Sum","family":"Foong","sequence":"additional","affiliation":[{"name":"Tufts Medical Center, Boston, Massachusetts, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2023,12,16]]},"reference":[{"key":"2025082800192093000_16.12.e258207.1","first-page":"1153","article-title":"Urinalysis: a comprehensive review","volume":"71","author":"Simerville","year":"2005","journal-title":"Am Fam Physician"},{"key":"2025082800192093000_16.12.e258207.2","first-page":"354","article-title":"Hemolytic anemia: evaluation and differential diagnosis","volume":"98","author":"Phillips","year":"2018","journal-title":"Am Fam Physician"},{"key":"2025082800192093000_16.12.e258207.3","doi-asserted-by":"publisher","DOI":"10.1016\/S0733-8619(05)70187-0"},{"key":"2025082800192093000_16.12.e258207.4","first-page":"299","article-title":"Jaundice in the adult patient","volume":"69","author":"Roche","year":"2004","journal-title":"Am Fam Physician"},{"key":"2025082800192093000_16.12.e258207.5","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(09)61925-5"},{"key":"2025082800192093000_16.12.e258207.6","doi-asserted-by":"crossref","first-page":"1082","DOI":"10.1177\/10600280211070029","article-title":"Dark red urine in a patient on Cefiderocol and Ferric Gluconate","volume":"56","author":"Lewis","year":"2022","journal-title":"Ann Pharmacother"},{"key":"2025082800192093000_16.12.e258207.7","doi-asserted-by":"crossref","DOI":"10.1111\/tid.14103","article-title":"The black urine challenge","volume":"25","author":"Lescroart","year":"2023","journal-title":"Transpl Infect Dis"},{"key":"2025082800192093000_16.12.e258207.8","first-page":"265","article-title":"Dark Brown urine in a patient treated with Cefiderocol","volume":"31","author":"Lupia","year":"2023","journal-title":"Infez Med"},{"key":"2025082800192093000_16.12.e258207.9","unstructured":"European Medicines Agency . Assessment report. Fetroja. Available: https:\/\/www.ema.europa.eu\/en\/documents\/assessment-report\/fetcroja-epar-public-assessment-report_en.pdf [Accessed 20 Aug 2023]."},{"key":"2025082800192093000_16.12.e258207.10","doi-asserted-by":"publisher","DOI":"10.1177\/009286150804200501"},{"key":"2025082800192093000_16.12.e258207.11","unstructured":"World Health Organization . Available: https:\/\/www.vigiaccess.org [Accessed 20 Aug 2023]."},{"key":"2025082800192093000_16.12.e258207.12","doi-asserted-by":"crossref","first-page":"20441","DOI":"10.1021\/acsomega.2c01833","article-title":"Iron absorption: factors, limitations, and improvement methods","volume":"7","author":"Piskin","year":"2022","journal-title":"ACS Omega"},{"key":"2025082800192093000_16.12.e258207.13","doi-asserted-by":"crossref","first-page":"1626","DOI":"10.1016\/j.ces.2007.11.016","article-title":"Mechanisms of formation of iron Precipitates from ferrous solutions at high and low pH","volume":"63","author":"Hove","year":"2008","journal-title":"Chemical Engineering Science"},{"key":"2025082800192093000_16.12.e258207.14","doi-asserted-by":"crossref","unstructured":"Tamma PD , Aitken SL , Bonomo RA , et al . Infectious diseases society of America 2023 guidance on the treatment of antimicrobial resistant gram-negative infections. Clin Infect Dis 2023. doi:10.1093\/cid\/ciad428","DOI":"10.1093\/cid\/ciad428"},{"key":"2025082800192093000_16.12.e258207.15","unstructured":"World Health Organization . Available: https:\/\/www.who.int\/news\/item\/27-02-2017-who-publishes-list-of-bacteria-for-which-new-antibiotics-are-urgently-needed [Accessed 27 Oct 2023]."},{"key":"2025082800192093000_16.12.e258207.16","doi-asserted-by":"publisher","DOI":"10.1016\/s0140-6736(21)02724-0"},{"key":"2025082800192093000_16.12.e258207.17","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2017.5150"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2023-258207","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,28]],"date-time":"2025-08-28T07:19:29Z","timestamp":1756365569000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2023-258207"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,12]]},"references-count":17,"journal-issue":{"issue":"12","published-online":{"date-parts":[[2023,12,16]]},"published-print":{"date-parts":[[2023,12]]}},"alternative-id":["10.1136\/bcr-2023-258207"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2023-258207","relation":{},"ISSN":["1757-790X"],"issn-type":[{"type":"electronic","value":"1757-790X"}],"subject":[],"published":{"date-parts":[[2023,12]]}}}