Abstract
To the Editor.— Adverse effects of treatment with cephalosporins include thrombophlebitis at the site of injection, serum-sickness-like syndrome, skin rash, hemolytic anemia, neutropenia, and toxic nephropathy. 1,2 We recently observed a cephaloridine-associated extrapyramidal syndrome, a complication to our knowledge hitherto undescribed. Report of a Case.— A 38-year-old Iraqian-born woman with a previous history of recurrent rheumatic fever was admitted to the Beilinson Medical Center with severe congestive heart failure, a combined mitral and aortic valvular lesion, tricuspid insufficiency and multiple ventricular extrasystoles, a normal temperature, and a blood pressure of 130/70 mm Hg. She was treated with digoxin, furosemide, and quinidine, subsequently substituted by diphenylhydantoin. Use of the latter drug was discontinued when a maculopapular rash and a hemolytic reaction with negative Coombs tests were observed. Both side effects receded rapidly. Patient's red blood cells were found to be devoid of glucose-6-phosphate dehydrogenase. Treatment of the ventricular extrasystoles was continued
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