https://doi.org/10.4081/itjm.2023.1665

Prolonged prothrombin time in a rare case of vitamin K deficiency: a case report and a narrative review

Vol. 17 No. 3 (2023)
Published: 21 November 2023
Vitamin K deficiency, cephalosporin, prolonged prothrombin time
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Authors

Matteo Nicoletto
drnicoletto.matteo@gmail.com
https://orcid.org/0000-0003-1981-6088
Department of Internal Medicine, Michele and Pietro Ferrero Hospital, Verduno (CN), Italy.
Eleonora Galli
https://orcid.org/0000-0001-6267-0526
Division of Internal Medicine, Department of Medical Sciences, University of Turin, Italy.
Alice Cerato
Division of Internal Medicine, Department of Medical Sciences, University of Turin, Italy.
Cristina Olivero
Division of Internal Medicine, Department of Medical Sciences, University of Turin, Italy.
Francisca Bulai
Division of Internal Medicine, Department of Medical Sciences, University of Turin, Italy.
Irene Praticò
Division of Internal Medicine, Department of Medical Sciences, University of Turin, Italy.
Fulvio Pomero
https://orcid.org/0000-0003-0991-2615
Department of Internal Medicine, Michele and Pietro Ferrero Hospital, Verduno (CN), Italy.

Prolonged prothrombin time increases the risk of bleeding complications in proportion to prolongation severity. We reported the case of a 72-year-old woman with a recent hospitalization for methicillin-susceptible Staphylococcus aureus endocarditis complicated by spondylodiscitis who developed a severe prolongation of clotting time during treatment with cefazolin due to a vitamin K deficiency. Cefazolin is a first-generation cephalosporin active against gram-positive bacteria. Like other cephalosporins, it is potentially able to inhibit the enzymes involved in recycling vitamin K metabolites, leading to a fall in gamma-carboxylation of vitamin K-dependent clotting factors. Clinicians should be aware of the necessity of regular monitoring of clotting times for the duration of antimicrobial therapy, especially in those patients with several risk factors for a poor vitamin K nutritional status. Prompt detection of vitamin K deficiency should be recognized and adequately supplemented.

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How to Cite

Nicoletto, M., Galli, E., Cerato, A., Olivero, C., Bulai, F., Praticò, I., & Pomero, F. (2023). Prolonged prothrombin time in a rare case of vitamin K deficiency: a case report and a narrative review. Italian Journal of Medicine, 17(3). https://doi.org/10.4081/itjm.2023.1665
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