title: A young infant with transient severe hypertriglyceridemia temporarily associated with meropenem administration: A case report and review of the literature.
abstract: BACKGROUND
  Slight changes in the lipid profile can be observed over the acute phase of infectious diseases. Moreover, some anti-infective drugs can modify serum lipid concentrations, although antibiotics do not seem to have a relevant, direct, or acute effect on the lipid profile.
  
  
  METHODS
  A 75-day-old breastfed Caucasian female, born at term after a regular pregnancy, was hospitalized for osteomyelitis. She was immediately treated with intravenous meropenem and vancomycin. Therapy was effective, but after 22 days of treatment, her blood was found to be viscous with a purple shade.
  
  
  RESULTS
  A fasting blood sample showed serum triglycerides of 966 mg/dL, total cholesterol of 258 mg/dL, and high-density lipoprotein cholesterol of 15 mg/dL. Secondary causes of hyperlipidemia and primary hereditary disorders were ruled out. Thereafter, the possibility that antibiotics may have had a role in the hypertriglyceridemia was considered, and meropenem was discontinued. After 72 hours of meropenem discontinuation, a sharp modification of lipid variables was observed, and further testing showed a complete normalization of the lipid profile.
  
  
  CONCLUSIONS
  In this child with osteomyelitis, the increase in serum triglycerides appeared suddenly after 3 weeks of meropenem treatment and resolved quickly after meropenem discontinuation, thus highlighting the possible association between meropenem and lipid profile alterations. Monitoring the lipid profile should be considered in cases of long-term treatment with meropenem, and further studies on meropenem safety should include evaluation of the lipid profile.
authors.affiliation: Pediatric Highly Intensive Care Unit, Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy Neonatal Intensive Care Unit, Department of Clinical Sciences and Community Health, Università degli Studi di Milano Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy Metabolic Disease Clinic, Geriatric Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy Pediatric Medium Intensity Care Unit, Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
authors.forename: Susanna
authors.initials: S
authors.lastname: Esposito
authors.forename: Raffaella
authors.initials: R
authors.lastname: Pinzani
authors.forename: Genny
authors.initials: G
authors.lastname: Raffaeli
authors.forename: Tiziano
authors.initials: T
authors.lastname: Lucchi
authors.forename: Carlo
authors.initials: C
authors.lastname: Agostoni
authors.forename: Nicola
authors.initials: N
authors.lastname: Principi
mesh_terms: D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000009:adverse effects*; D002784:Cholesterol / Q000097:blood; D008076:Cholesterol, HDL / Q000097:blood; D004359:Drug Therapy, Combination; D005215:Fasting / Q000097:blood; D005260:Female; D006801:Humans; D015228:Hypertriglyceridemia / Q000097:blood / Q000139:chemically induced*; D007223:Infant; D050356:Lipid Metabolism / Q000187:drug effects; D008055:Lipids / Q000097:blood; D000077731:Meropenem; D010019:Osteomyelitis / Q000188:drug therapy*; D013845:Thienamycins / Q000008:administration & dosage / Q000009:adverse effects*; D014280:Triglycerides / Q000097:blood; D014640:Vancomycin / Q000008:administration & dosage
chemical_list: D000900:Anti-Bacterial Agents; D008076:Cholesterol, HDL; D008055:Lipids; D013845:Thienamycins; D014280:Triglycerides; D014640:Vancomycin; D002784:Cholesterol; D000077731:Meropenem