Acute myocardial injury and acute heart failure induced by cefotaxime sodium

A 30-year-old female patient received an IV infusion of cefotaxime sodium 1.0 g for toothache. About 20 minutes later, the patient developed chest tightness, palpitation, and limbs shaking. The drug was immediately stopped and an IV injection of dexamethasone was given. However, the symptoms were not improved and the patient was presented to emergency department in our hospital. On admission, electrocardiogram revealed acute myocardial ischemia, troponin T (TnT) 0.033 μg/L, creatine kinase (CK) 175 U/L, creatine kinase isoenzyme MB (CK-MB) 2.95 μg/L. About 0.5 hour of admission, the patient developed asthmatic symptoms and coughed up pink frothy sputum. Ventilator support, morphine, torasemide, dopamine, nitroglycerin, and diprophylline were given. About 4.5 hours of admission, her symptoms were improved. About 7 hours of admission, TnT was 0.551 μg/L, CK-MB 2.95 μg/L, myohemoglobin 149 μg/L. Five days of admission, ECG returned to normal and 1 week later, TnT, CK-MB and myohemoglobin levels returned to normal. Key words: Cefotaxime sodium; Myocardial ischemia; Heart failure