Ceftriaxone associated hemolysis

A 48-year-old immunocompetent women treated with ceftriaxone 2 g daily iv. for late Lyme borreliosis developed severe haemolytic anaemia. The patient had previously received the same antibiotic two times without any side effe cts. The first clinical signs began to appear on the seventh day of treatme nt. The patient developed severe anaemia with a haemoglobin level of 45 mg/ l on day 10; thereafter she ceased to receive the antibiotic. The outcome w as favourable. The clinical course and serologic results suggest that sever e anaemia was induced by ceftriaxone and that drug adsorption as well as im mune complex mechanisms were involved in the pathogenesis.