Ciprofloxacin
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Acute haemolytic anaemia in an elderly patient: case report An 88-year-old woman developed acute haemolytic anaemia following treatment with ciprofloxacin for fever and persistent diarrhoea. The woman, who had glucose-6-phosphate dehydrogenase deficiency, had been hospitalised for nausea, vomiting and diarrhoea following her first cycle of chemotherapy. She was treated with metoclopramide, but diarrhoea persisted and she had an elevated body temperature. She received IV ciprofloxacin 500 mg/day. She developed shortness of breath following the second ciprofloxacin dose and became cyanotic on days 3 and 4. Investigations revealed that her haematocrit and haemoglobin levels had decreased to 17.7% and 6.4 g/dL, respectively, her LDH and total bilirubin levels were elevated and her haptoglobin level was low. She was treated with intravenous hydration and RBC transfusion. Ciprofloxacin was discontinued and the woman received piperacillin/tazobactam, with intravenous nutrition instead of enteral nutrition. She was discharged on day 30 with haematocrit of 33.6%, a haemoglobin level of 11.5 g/dL and her LDH had returned to near-normal levels. Author comment: The Naranjo probability scale "demonstrated a probable likelihood that ciprofloxacin was the cause of acute haemolysis in our patient". Sansone S, et al. Ciprofloxacin-induced acute haemolytic anaemia in a patient with glucose-6-phosphate dehydrogenase Mediterranean deficiency: a case report. 803038648 Annals of Hematology 89: 935-7, Sep 2010 - Italy
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Reactions 18 Sep 2010 No. 1319
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