{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T17:28:52Z","timestamp":1790270932658,"version":"4.1.0"},"reference-count":35,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,1,7]],"date-time":"2025-01-07T00:00:00Z","timestamp":1736208000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Pharmacol."],"abstract":"<jats:p>Ceftriaxone is widely used in clinical practice for its efficacy against infections. However, its increasing association with life-threatening immune hemolytic reactions urge clinicians to enhance recognition and maintain sharp vigilance. This report details a rare and severe case of ceftriaxone-induced hemolytic anemia (CIHA), hemodynamic instability and hemolytic crisis in a 54-year-old woman after intravenous infusion of ceftriaxone following a respiratory infection. Clinicians must promptly identify symptoms suggestive of CIHA, such as fatigue, pallor, nausea, vomiting, and trunk pain, and immediately discontinue ceftriaxone. Laboratory examination can also assist in confirming the diagnosis of CIHA. Effective management measures include rigorous monitoring of vital signs, circulatory support, respiratory support, timely blood transfusion, administration of steroid hormones, IVIG infusion as necessary, plasma exchange, and symptomatic treatment of possible complications. Even after the patient has achieved full recovery, careful consideration should be given to the choice of subsequent antibiotics to prevent recurrence of CIHA.<\/jats:p>","DOI":"10.3389\/fphar.2024.1505366","type":"journal-article","created":{"date-parts":[[2025,1,7]],"date-time":"2025-01-07T07:56:08Z","timestamp":1736236568000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":5,"title":["Ceftriaxone-induced hemolytic anemia managed successfully in a 54-year-old woman: a case report and literature review"],"prefix":"10.3389","volume":"15","author":[{"given":"Liqian","family":"Zhang","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wenfeng","family":"Huang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiakai","family":"Xu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yunxing","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jihong","family":"Zhu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2025,1,7]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"44","DOI":"10.21307\/immunohematology-2019-098","article-title":"Drug-induced immune hemolytic anemia: the last 30 years of changes","volume":"30","author":"Arndt","year":"2014","journal-title":"Immunohematology"},{"key":"B2","doi-asserted-by":"publisher","first-page":"602","DOI":"10.1111\/j.1537-2995.2011.03321.x","article-title":"Serologic characteristics of ceftriaxone antibodies in 25 patients with drug-induced immune hemolytic anemia","volume":"52","author":"Arndt","year":"2012","journal-title":"Transfusion"},{"key":"B3","doi-asserted-by":"publisher","first-page":"e1289","DOI":"10.1542\/peds.2010-1570","article-title":"Ceftriaxone-induced hemolysis in a child with Lyme arthritis: a case for antimicrobial stewardship","volume":"128","author":"Boggs","year":"2011","journal-title":"Pediatrics"},{"key":"B4","doi-asserted-by":"publisher","first-page":"752","DOI":"10.1097\/INF.0000000000001159","article-title":"A randomized, prospective study of pediatric patients with community-acquired pneumonia treated with ceftaroline versus ceftriaxone","volume":"35","author":"Cannavino","year":"2016","journal-title":"Pediatr. Infect. Dis. J."},{"key":"B5","doi-asserted-by":"publisher","first-page":"103","DOI":"10.3390\/pharmacy7030103","article-title":"Cephalosporins: a focus on side chains and \u03b2-lactam cross-reactivity","volume":"7","author":"Chaudhry","year":"2019","journal-title":"Pharm. (Basel)."},{"key":"B6","doi-asserted-by":"publisher","first-page":"4105653","DOI":"10.1155\/2019\/4105653","article-title":"Ceftriaxone-induced immune hemolytic anemia: in vitro reversal with peptide inhibitor of complement C1 (PIC1)","volume":"2019","author":"Cunnion","year":"2019","journal-title":"Case Rep. Hematol."},{"key":"B7","doi-asserted-by":"publisher","first-page":"e59646","DOI":"10.7759\/cureus.59646","article-title":"Ceftriaxone-induced hemolytic anemia: a rare and fatal reaction","volume":"16","author":"Dicaro","year":"2024","journal-title":"Cureus"},{"key":"B8","doi-asserted-by":"publisher","first-page":"73","DOI":"10.1182\/asheducation-2009.1.73","article-title":"Drug-induced immune hemolytic anemia","volume":"2009","author":"Garratty","year":"2009","journal-title":"Hematol. Am. Soc. Hematol. Educ. Program"},{"key":"B9","doi-asserted-by":"publisher","first-page":"143","DOI":"10.1016\/j.blre.2010.06.004","article-title":"Immune hemolytic anemia associated with drug therapy","volume":"24","author":"Garratty","year":"2010","journal-title":"Blood Rev."},{"key":"B10","doi-asserted-by":"publisher","first-page":"322","DOI":"10.1097\/PEC.0b013e3182131fa8","article-title":"Severe hemolytic crisis after ceftriaxone administration","volume":"27","author":"Goyal","year":"2011","journal-title":"Pediatr. Emerg. Care"},{"key":"B11","doi-asserted-by":"publisher","first-page":"293","DOI":"10.53854\/liim-3002-16","article-title":"A case of ceftriaxone-induced liver injury and literature review","volume":"30","author":"Guarino","year":"2022","journal-title":"Infez. Med."},{"key":"B12","doi-asserted-by":"publisher","first-page":"208","DOI":"10.1111\/bjh.14654","article-title":"Guidelines on the management of drug-induced immune and secondary autoimmune, haemolytic anaemia","volume":"177","author":"Hill","year":"2017","journal-title":"Br. J. Haematol."},{"key":"B13","doi-asserted-by":"publisher","first-page":"513","DOI":"10.1159\/000529110","article-title":"Adverse reactions associated with intravenous immunoglobulin administration in the treatment of neurological disorders: a systematic review","volume":"184","author":"Jiang","year":"2023","journal-title":"Int. Arch. Allergy Immunol."},{"key":"B14","doi-asserted-by":"publisher","first-page":"9841097","DOI":"10.1155\/2020\/9841097","article-title":"Co-amoxiclav induced immune haemolytic anaemia: a case report","volume":"2020","author":"Karunathilaka","year":"2020","journal-title":"Case Rep. Hematol."},{"key":"B15","doi-asserted-by":"publisher","first-page":"67","DOI":"10.1186\/s40360-018-0257-7","article-title":"Ceftriaxone-induced hemolytic anemia with severe renal failure: a case report and review of literature","volume":"19","author":"Leicht","year":"2018","journal-title":"BMC Pharmacol. Toxicol."},{"key":"B16","doi-asserted-by":"publisher","first-page":"1390082","DOI":"10.3389\/fimmu.2024.1390082","article-title":"Case report: decreased hemoglobin and multiple organ failure caused by ceftizoxime-induced immune hemolytic anemia in a Chinese patient with malignant rectal cancer","volume":"15","author":"Lou","year":"2024","journal-title":"Front. Immunol."},{"key":"B17","doi-asserted-by":"publisher","first-page":"817","DOI":"10.1182\/bloodadvances.2023009801","article-title":"Drug-induced immune hemolytic anemia: detection of new signals and risk assessment in a nationwide cohort study","volume":"8","author":"Maquet","year":"2023","journal-title":"Blood Adv."},{"key":"B18","doi-asserted-by":"publisher","first-page":"333","DOI":"10.1159\/000440673","article-title":"Variability of findings in drug-induced immune haemolytic anaemia: experience over 20 Years in a single centre","volume":"42","author":"Mayer","year":"2015","journal-title":"Transfus. Med. Hemother"},{"key":"B19","doi-asserted-by":"publisher","first-page":"1","DOI":"10.24966\/NCP-878X\/100101","article-title":"A near fatal ceftriaxone-induced hemolytic anemia in pediatric age: case report","volume":"9","author":"Miranda","year":"2022","journal-title":"NCP"},{"key":"B20","doi-asserted-by":"publisher","first-page":"1594","DOI":"10.1177\/1060028014548310","article-title":"Ceftriaxone-induced immune hemolytic anemia","volume":"48","author":"Neuman","year":"2014","journal-title":"Ann. Pharmacother."},{"key":"B21","doi-asserted-by":"publisher","first-page":"e63","DOI":"10.1097\/MPH.0000000000000181","article-title":"Ceftriaxone-induced hemolytic anemia: case report and review of literature","volume":"37","author":"Northrop","year":"2015","journal-title":"J. Pediatr. Hematology\/Oncology"},{"key":"B22","doi-asserted-by":"publisher","first-page":"634","DOI":"10.1128\/aac.20.5.634","article-title":"Pharmacokinetics of ceftriaxone in humans","volume":"20","author":"Patel","year":"1981","journal-title":"Antimicrob. Agents Chemother."},{"key":"B23","doi-asserted-by":"publisher","first-page":"e4688","DOI":"10.7759\/cureus.4688","article-title":"A case of confirmed ceftriaxone-induced immune thrombocytopenia","volume":"11","author":"Piedra Abusharar","year":"2019","journal-title":"Cureus"},{"key":"B24","doi-asserted-by":"publisher","first-page":"7","DOI":"10.1309\/AJCPBVLJZH6W6RQM","article-title":"Pathology consultation on drug-induced hemolytic anemia","volume":"136","author":"Pierce","year":"2011","journal-title":"Am. J. Clin. Pathology"},{"key":"B25","doi-asserted-by":"publisher","first-page":"110","DOI":"10.1016\/j.tracli.2017.05.013","article-title":"Drug-induced hemolytic anemia: pharmacological aspects","volume":"24","author":"Renard","year":"2017","journal-title":"Transfus. Clin. Biol."},{"key":"B26","doi-asserted-by":"publisher","first-page":"107309","DOI":"10.1016\/j.ijantimicag.2024.107309","article-title":"Meta-analysis on safety of standard vs prolonged infusion of beta-lactams","volume":"64","author":"Rolain","year":"2024","journal-title":"Int. J. Antimicrob. Agents"},{"key":"B27","doi-asserted-by":"publisher","first-page":"73","DOI":"10.1517\/14740330802577351","article-title":"Drug-induced immune hemolytic anemia","volume":"8","author":"Salama","year":"2009","journal-title":"Expert Opin. Drug Saf."},{"key":"B28","doi-asserted-by":"publisher","first-page":"80","DOI":"10.21307\/immunohematology-2019-101","article-title":"Diagnostic pitfalls of drug-induced immune hemolytic anemia","volume":"30","author":"Salama","year":"2014","journal-title":"Immunohematology"},{"key":"B29","doi-asserted-by":"publisher","first-page":"e8660","DOI":"10.7759\/cureus.8660","article-title":"Ceftriaxone-induced immune hemolytic anemia","volume":"12","author":"Singh","year":"2020","journal-title":"Cureus"},{"key":"B30","doi-asserted-by":"publisher","first-page":"e136","DOI":"10.11622\/smedj.2014111","article-title":"Drug-induced immune haemolytic anaemia caused by levofloxacin","volume":"55","author":"Sukhal","year":"2014","journal-title":"Singap. Med. J."},{"key":"B31","doi-asserted-by":"publisher","first-page":"1362668","DOI":"10.3389\/fphar.2024.1362668","article-title":"Ceftriaxone-induced severe hemolytic anemia, renal calculi, and cholecystolithiasis in a 3-year-old child: a case report and literature review","volume":"15","author":"Tao","year":"2024","journal-title":"Front. Pharmacol."},{"key":"B32","doi-asserted-by":"publisher","first-page":"431","DOI":"10.12659\/AJCR.903507","article-title":"Ceftriaxone-induced hemolytic anemia in a jehovah\u2019s witness","volume":"18","author":"Tasch","year":"2017","journal-title":"Am. J. Case Rep."},{"key":"B33","doi-asserted-by":"publisher","first-page":"216","DOI":"10.24953\/turkjped.2016.02.016","article-title":"Ceftriaxone-induced hemolytic anemia in a child successfully managed with intravenous immunoglobulin","volume":"58","author":"Vehapo\u011flu","year":"2016","journal-title":"Turk J. Pediatr."},{"key":"B34","doi-asserted-by":"publisher","first-page":"723167","DOI":"10.3389\/fmed.2021.723167","article-title":"Case report: oral cimetidine administration causes drug-induced immune hemolytic anemia by eliciting the production of cimetidine-dependent antibodies and drug-independent non-specific antibodies","volume":"8","author":"Wu","year":"2021","journal-title":"Front. Med. (Lausanne)"},{"key":"B35","doi-asserted-by":"publisher","first-page":"981","DOI":"10.1136\/archdischild-2019-317950","article-title":"Safety of ceftriaxone in paediatrics: a systematic review","volume":"105","author":"Zeng","year":"2020","journal-title":"Arch. Dis. Child."}],"container-title":["Frontiers in Pharmacology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fphar.2024.1505366\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,1,7]],"date-time":"2025-01-07T07:56:09Z","timestamp":1736236569000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fphar.2024.1505366\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,1,7]]},"references-count":35,"alternative-id":["10.3389\/fphar.2024.1505366"],"URL":"https:\/\/doi.org\/10.3389\/fphar.2024.1505366","relation":{},"ISSN":["1663-9812"],"issn-type":[{"value":"1663-9812","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,1,7]]},"article-number":"1505366"}}