Life-threatening coagulopathy and hypofibrinogenaemia induced by tigecycline in a patient with advanced liver cirrhosis

Eur J Gastroenterol Hepatol. 2014 Jun;26(6):681-4. doi: 10.1097/MEG.0000000000000087.

Abstract

Bacterial infections because of multidrug-resistant (MDR) bacteria are spreading worldwide. In patients with advanced liver cirrhosis, healthcare-acquired and hospital-acquired infections are common and are frequently sustained by MDR bacteria. In these settings, tigecycline, a new antibiotic, has been shown to be useful in the treatment of MDR bacteria, and it has been proposed for the treatment of hospital-acquired infections in patients with cirrhosis. Nevertheless, poor data exist on the safety profile of tigecycline in patients with cirrhosis. Here, an experience is reported in a female patient with advanced liver cirrhosis, who developed sepsis by an MDR Stenotrophomonas maltophilia and was treated with tigecycline. She experienced life-threatening side effects consisting of severe coagulopathy with hypofibrinogenaemia and subsequent gastrointestinal haemorrhage. The side effect disappeared after the withdrawal of tigecycline. Therefore, a strict monitoring of coagulation parameters in patients with cirrhosis treated with tigecycline is recommended.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Afibrinogenemia / chemically induced
  • Anti-Bacterial Agents / adverse effects*
  • Blood Coagulation Disorders / chemically induced*
  • Cross Infection / complications
  • Cross Infection / drug therapy*
  • Drug Resistance, Multiple, Bacterial
  • Female
  • Gram-Negative Bacterial Infections / drug therapy
  • Humans
  • Liver Cirrhosis / complications*
  • Minocycline / adverse effects
  • Minocycline / analogs & derivatives*
  • Opportunistic Infections / complications
  • Opportunistic Infections / drug therapy
  • Stenotrophomonas maltophilia
  • Tigecycline

Substances

  • Anti-Bacterial Agents
  • Tigecycline
  • Minocycline

Supplementary concepts

  • Stenotrophomonas maltophilia bacteremia