Positive Direct Coombs Tests Due to Cephalothin

Abstract

A TWENTY-SEVEN-year-old woman with rheumatic heart disease had open-heart surgery on April 5, 1966. The direct Coombs tests before operation were negative. She was studied nine days later because of anemia and had a strongly positive direct Coombs test. Isoimmunization to donor cells transfused during surgery was ruled out by an appropriate elution technic. The indirect Coombs test was negative. The patient had been receiving cephalothin (4 gm. daily) in addition to other drugs since April 7. A diagnosis of hemolytic anemia due to cephalothin was considered, blood transfusions were given, and attempts were made to elucidate the mechanism of . . .