Drug-induced hemolytic anemia (HA) is a very rare state in childhood. Second- and third-generation cephalosporins are the most common cause of drug-induced HA. More than 50% of all reported cases of HA associated with third-generation cephalosporins are related to ceftriaxone. We herein report a six-year-old girl who developed HA during ceftriaxone treatment. She received intravenous ceftriaxone, which was combined with vancomycin and teicoplanin for purulent meningitis. Vancomycin treatment was withdrawn because she developed a maculopapular rash. When she appeared pale and had vomiting, tachypnea, and back pain, laboratory investigations revealed: hemoglobin 4.3 g/dl, reticulocytes 1%, lactate dehydrogenase (LDH) 1346 U/L, total bilirubin 11.8 g/dl, direct bilirubin 2.9 g/dl, haptoglobin 13.9 mg/dl, urobilinogen (+2), and direct Coombs test (positive). HA was assumed to be induced by ceftriaxone and ceftriaxone treatment was withdrawn. Therapy was completed with teicoplanin. By the second week after discharge from the hospital, her hemoglobin level was stable.

Keywords: hemolitik anemi, seftriakson.