Bloody Stools in the Emergency Room: Cefdinir-Induced Red Stools in a 7-Month-Old Male

Area of Science:

• Pediatrics
• Gastroenterology
• Pharmacology

Background:

• Infants with a history of milk protein allergy and eczema are susceptible to various conditions.
• Ear infections are common in infants and often treated with antibiotics like cefdinir.
• Iron supplementation is frequently used in infant formulas to prevent anemia.

Observation:

• A 7-month-old male presented with red-colored stools, prompting an emergency room visit.
• Initial investigations revealed elevated white blood cell count, mild anemia, and hyperkalemia.
• A stool heme-occult test was negative, ruling out gastrointestinal bleeding.

Findings:

• Cefdinir-induced stool discoloration, a rare benign side effect, was considered due to the negative stool occult blood test.
• This discoloration occurs when cefdinir is co-administered with iron supplementation.
• Symptoms resolved completely upon discontinuation of cefdinir.

Implications:

• Cefdinir-induced red stool discoloration should be considered in the differential diagnosis of infants presenting with "bloody" stools.
• This highlights the importance of considering medication side effects in pediatric presentations.
• Accurate diagnosis prevents unnecessary investigations and interventions for gastrointestinal bleeding.