Cefoperazone-induced severe coagulopathy in a patient without classical risk factors: A case report

Cefoperazone-induced coagulopathy typically occurs in critically ill patients with established risk factors. We report the case of a 58-year-old previously healthy male who developed severe coagulopathy on day six of cefoperazone therapy for Pseudomonas pneumonia, despite lacking traditional risk factors such as critical illness, renal impairment, or hypoalbuminemia. The patient presented with spontaneous ecchymoses, hematuria, and epistaxis with markedly elevated prothrombin time and international normalized ratio. Investigation revealed 1 month of dietary inadequacy, suggesting subclinical Vitamin K deficiency as a predisposing factor. Immediate cefoperazone discontinuation and intravenous Vitamin K administration resulted in complete resolution within 72 h. This case emphasizes the importance of nutritional assessment and enhanced monitoring even in apparently low-risk patients receiving cefoperazone therapy.