PDF(Pubmed)
Abstract：
This case report presents a rare occurrence of coagulopathy induced by antibiotics in a woman in her 90s with chronic bowel obstruction and massive colon cancer. The patient developed vitamin K deficiency-related coagulopathy following antibiotic administration, resulting in bleeding complications. Despite initial consideration of disseminated intravascular coagulation, further investigations revealed antibiotic-induced vitamin K deficiency. Prompt discontinuation of antibiotics and IV vitamin K2 administration led to the resolution of coagulopathy. The case emphasizes the importance of cautious antibiotic use in patients with chronic bowel obstruction and prolonged fasting. The protein induced by vitamin K absence-II (PIVKA-II) proved valuable in diagnosing vitamin K deficiency. The learning points include the potential for coagulopathy with antibiotics in prolonged bowel obstruction and the utility of PIVKA-II in assessing vitamin K deficiency. Healthcare providers should exercise caution when administering antibiotics in similar clinical scenarios.
摘要：
该病例报告显示，在90年代患有慢性肠梗阻和大量结肠癌的女性中，抗生素引起的凝血病很少发生。患者在服用抗生素后出现了维生素K缺乏相关的凝血病，导致出血并发症。尽管最初考虑了弥散性血管内凝血，进一步的调查显示抗生素引起的维生素K缺乏.及时停用抗生素和静脉注射维生素K2可导致凝血病的缓解。该病例强调了慢性肠梗阻和长期禁食患者谨慎使用抗生素的重要性。维生素K缺乏II（PIVKA-II）诱导的蛋白质在诊断维生素K缺乏症中被证明是有价值的。学习要点包括抗生素在长期肠梗阻中的凝血功能障碍的可能性以及PIVKA-II在评估维生素K缺乏症中的实用性。在类似的临床情况下使用抗生素时，医疗保健提供者应谨慎行事。
