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Pathology
A 33-year-old previously healthy man with persistent fever and heart murmur is diagnosed with infective endocarditis. He receives a high dosage of a cephalosporin antibiotic during the next 10 days. He now has increasing fatigue. On physical examination, he has tachycardia and scleral icterus. Laboratory studies show a hemoglobin level of 7.5 g/dL, platelet count of 261,000/ mm3, and total WBC count of 8300/ mm3. The direct Coombs test is positive. The peripheral blood smear shows reticulocytosis. Which of the following is the most likely cause of his anemia?
Dietary nutrient deficiency
Disseminated intravascular coagulopathy
Immune-mediated hemolysis
Infection with parvovirus
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