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Pyelonephritis is a bacterial infection that primarily affects the renal parenchyma and collecting system, including the renal pelvis, tubules, and interstitial tissue of one or both kidneys. It can be classified as either acute—a sudden, severe infection—or chronic, which refers to long-term or recurrent kidney infections.The primary cause of acute pyelonephritis (APN) is bacterial infection, with Escherichia coli accounting for approximately 70-80% of cases. Other bacteria, such as Proteus,...

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Ceftriaxone-Induced Pancytopenia: A Case Report.

Edin Karisik¹, Zorica Stanojevic-Ristic², Marija Jevtic³

¹Department of Internal Medicine, General Hospital Novi Pazar, 36300 Novi Pazar, Serbia.

Hematology Reports

|June 25, 2025

Summary

Ceftriaxone, a common antibiotic, can rarely cause pancytopenia (low blood counts). Prompt drug withdrawal and supportive care led to recovery, highlighting the need for vigilance with antibiotic-induced cytopenias.

Keywords:

antibiotics ceftriaxone filgrastim idiosyncrasy pancytopenia

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Area of Science:

Hematology
Pharmacology
Internal Medicine

Background:

Cephalosporins are generally considered safe antibiotics.
Rarely, serious hematological abnormalities can occur following cephalosporin therapy.
This case highlights a potential adverse effect of a widely used antibiotic.

Observation:

A 72-year-old female developed pancytopenia after five days of ceftriaxone treatment for a urinary tract infection.
Extensive diagnostic workup excluded other causes of cytopenia.
Bone marrow aspiration revealed hypocellularity without malignancy; peripheral smear showed no dysplasia or hemolysis.

Findings:

Ceftriaxone was identified as the likely cause of drug-induced pancytopenia.
Discontinuation of ceftriaxone and administration of granulocyte colony-stimulating factor (G-CSF) resulted in significant clinical improvement.
The patient's recovery suggests an idiosyncratic, immune-mediated mechanism.

Implications:

Clinicians should maintain a high index of suspicion for drug-induced cytopenias in patients receiving antibiotics.
Thorough medication history and exclusion of alternative causes are crucial for diagnosis.
Further research into pharmacogenomic screening, particularly involving HLA variants, may identify patients at increased risk for such adverse events.