A severe case of cefoxitin-induced immune hemolytic anemia

Acta Haematol. 2010;124(4):197-9. doi: 10.1159/000320169. Epub 2010 Nov 2.


Drug-induced immune hemolytic anemia is a rare but underdiagnosed and potentially fatal condition. We report a case of severe hemolytic anemia induced by cefoxitin in a 45-year-old woman admitted with menometrorrhagia. Hemoglobin levels reached a nadir of 4.7 g/dl approximately 72 h after cefoxitin initiation, and hemolysis resolved when cefoxitin was discontinued and prednisone 1 mg/kg was initiated. A transfusion reaction workup revealed no abnormalities. Direct antiglobulin testing was weakly positive with anti-C3. The patient's plasma and RBC eluate reacted with cefoxitin-treated RBCs but not with untreated RBCs in the presence or absence of cefoxitin.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Anemia, Hemolytic / chemically induced*
  • Anti-Bacterial Agents / adverse effects*
  • Blood Transfusion
  • Cefoxitin / adverse effects*
  • Female
  • Humans
  • Leiomyoma / blood
  • Menorrhagia / drug therapy
  • Prednisone / therapeutic use


  • Anti-Bacterial Agents
  • Cefoxitin
  • Prednisone