Open AccessHypofibrinogenemia induced by high-dose tigecycline—case report and review of literature
Author(s) -
Qiaomei Fan,
Wei Huang,
Yuanyuan Weng,
Xianze Xie,
Zhicai Shi
Publication year - 2020
Publication title -
medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.59
H-Index - 148
eISSN - 1536-5964
pISSN - 0025-7974
DOI - 10.1097/md.0000000000022638
Subject(s) - hypofibrinogenemia , tigecycline , medicine , fibrinogen , coagulopathy , coagulation , surgery , intensive care medicine , antibiotics , microbiology and biotechnology , biology
Rationale: Extensive off-label use may affect the safety profile of tigecycline. Tigecycline-associated hypofibrinogenemia is potentially life threatening, although the frequency of life-threatening reactions is unknown and their incidence is easily overlooked. We report a case of 2 instances of treatment with high-dose tigecycline, each of which presented with hypofibrinogenemia. Patient concerns: An 86-year-old male patient was treated twice with high-dose tigecycline and presented with hypofibrinogenemia both times. The decrease in fibrinogen occurred within 3 to 7 days of tigecycline treatment. Other coagulation parameters had slightly prolonged values. Diagnoses: Coagulopathy and hypofibrinogenemia. Interventions: We discontinued the tigecycline. Outcomes: The fibrinogen level normalized within 5 days after the withdrawal of tigecycline. Following 80 days of hospitalization, the patient was transferred to the rehabilitation hospital for further treatment. Lessons: We suggest routine strict monitoring of coagulation parameters, particularly fibrinogen. Attention should be paid to below-normal fibrinogen levels due to increased bleeding risk and severity of reaction at fibrinogen levels below 1 g/L.