Ceftriaxone-induced immune hemolytic anemia as a life-threatening complication of antibiotic treatment of 'chronic Lyme disease'

Acta Clin Belg. 2017 Apr;72(2):133-137. doi: 10.1080/17843286.2016.1180829. Epub 2016 May 12.


'Chronic Lyme disease' is a controversial condition. As any hard evidence is lacking that unresolved systemic symptoms, following an appropriately diagnosed and treated Lyme disease, are related to a chronic infection with the tick-borne spirochaetes of the Borrelia genus, the term 'chronic Lyme disease' should be avoided and replaced by the term 'post-treatment Lyme disease syndrome.' The improper prescription of prolonged antibiotic treatments for these patients can have an impact on the community antimicrobial resistance and on the consumption of health care resources. Moreover, these treatments can be accompanied by severe complications. In this case report, we describe a life-threatening ceftriaxone-induced immune hemolytic anemia with an acute kidney injury (RIFLE-stadium F) due to a pigment-induced nephropathy in a 76-year-old woman, who was diagnosed with a so-called 'chronic Lyme disease.'

Keywords: Ceftriaxone; Drug-induced hemolytic anemia; ‘Chronic Lyme disease’.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Anemia, Hemolytic, Autoimmune / chemically induced*
  • Anti-Bacterial Agents / adverse effects*
  • Ceftriaxone / adverse effects*
  • Chronic Disease
  • Female
  • Humans
  • Lyme Disease / drug therapy*


  • Anti-Bacterial Agents
  • Ceftriaxone