Rivaroxaban-induced spontaneous hemothorax: a rare case report and literature review
IntroductionRivaroxaban, a novel oral anticoagulant, is widely used in patients with non-valvular atrial fibrillation. Bleeding events during rivaroxaban therapy most commonly include gastrointestinal bleeding and intracranial hemorrhage, while spontaneous hemothorax is exceedingly rare. We report a...
Saved in:
| Main Authors: | , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Frontiers Media S.A.
2025-07-01
|
| Series: | Frontiers in Medicine |
| Subjects: | |
| Online Access: | https://www.frontiersin.org/articles/10.3389/fmed.2025.1641092/full |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1849245874662670336 |
|---|---|
| author | Xiaolong Li Shuhao Xu Chunfang Zeng Ding Han Xin Wang |
| author_facet | Xiaolong Li Shuhao Xu Chunfang Zeng Ding Han Xin Wang |
| author_sort | Xiaolong Li |
| collection | DOAJ |
| description | IntroductionRivaroxaban, a novel oral anticoagulant, is widely used in patients with non-valvular atrial fibrillation. Bleeding events during rivaroxaban therapy most commonly include gastrointestinal bleeding and intracranial hemorrhage, while spontaneous hemothorax is exceedingly rare. We report a case of spontaneous hemothorax occurring during rivaroxaban administration.MethodsWe report the case of a patient presenting primarily with dyspnea. The patient had been on long-term oral rivaroxaban for atrial fibrillation. Physical examination upon admission revealed diminished breath sounds in the left lung. Computed tomography imaging demonstrated a large left-sided pleural effusion with adjacent pulmonary atelectasis. Laboratory tests indicated significant coagulation abnormalities. After admission, the patient underwent therapeutic thoracentesis and chest tube placement, with bloody pleural fluid observed in the drainage. Due to the marked coagulation abnormalities on admission, the patient received fresh frozen plasma transfusion. Further history-taking revealed recent use of oral fluconazole. A review of the literature suggested that the spontaneous hemothorax might be associated with the concurrent use of rivaroxaban and fluconazole.ResultsFollowing treatment, a follow-up computed tomography scan 3 months later showed no evidence of recurrent hemothorax.DiscussionConcomitant administration of rivaroxaban and fluconazole significantly increases the risk of bleeding events, necessitating clinician vigilance regarding potential drug–drug interactions when formulating therapeutic regimens. |
| format | Article |
| id | doaj-art-b4caeaa2775f4770ac1f5375c749d6ce |
| institution | Kabale University |
| issn | 2296-858X |
| language | English |
| publishDate | 2025-07-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Medicine |
| spelling | doaj-art-b4caeaa2775f4770ac1f5375c749d6ce2025-08-20T03:58:40ZengFrontiers Media S.A.Frontiers in Medicine2296-858X2025-07-011210.3389/fmed.2025.16410921641092Rivaroxaban-induced spontaneous hemothorax: a rare case report and literature reviewXiaolong Li0Shuhao Xu1Chunfang Zeng2Ding Han3Xin Wang4Pulmonary and Critical Care Medicine, Deyang People’s Hospital, Deyang, ChinaDepartment of Stomatology, Deyang People's Hospital, Deyang, ChinaPulmonary and Critical Care Medicine, Deyang People’s Hospital, Deyang, ChinaPulmonary and Critical Care Medicine, Deyang People’s Hospital, Deyang, ChinaPulmonary and Critical Care Medicine, Deyang People’s Hospital, Deyang, ChinaIntroductionRivaroxaban, a novel oral anticoagulant, is widely used in patients with non-valvular atrial fibrillation. Bleeding events during rivaroxaban therapy most commonly include gastrointestinal bleeding and intracranial hemorrhage, while spontaneous hemothorax is exceedingly rare. We report a case of spontaneous hemothorax occurring during rivaroxaban administration.MethodsWe report the case of a patient presenting primarily with dyspnea. The patient had been on long-term oral rivaroxaban for atrial fibrillation. Physical examination upon admission revealed diminished breath sounds in the left lung. Computed tomography imaging demonstrated a large left-sided pleural effusion with adjacent pulmonary atelectasis. Laboratory tests indicated significant coagulation abnormalities. After admission, the patient underwent therapeutic thoracentesis and chest tube placement, with bloody pleural fluid observed in the drainage. Due to the marked coagulation abnormalities on admission, the patient received fresh frozen plasma transfusion. Further history-taking revealed recent use of oral fluconazole. A review of the literature suggested that the spontaneous hemothorax might be associated with the concurrent use of rivaroxaban and fluconazole.ResultsFollowing treatment, a follow-up computed tomography scan 3 months later showed no evidence of recurrent hemothorax.DiscussionConcomitant administration of rivaroxaban and fluconazole significantly increases the risk of bleeding events, necessitating clinician vigilance regarding potential drug–drug interactions when formulating therapeutic regimens.https://www.frontiersin.org/articles/10.3389/fmed.2025.1641092/fullrivaroxabanfluconazolespontaneous hemothoraxdrug–drug interactioncase report |
| spellingShingle | Xiaolong Li Shuhao Xu Chunfang Zeng Ding Han Xin Wang Rivaroxaban-induced spontaneous hemothorax: a rare case report and literature review Frontiers in Medicine rivaroxaban fluconazole spontaneous hemothorax drug–drug interaction case report |
| title | Rivaroxaban-induced spontaneous hemothorax: a rare case report and literature review |
| title_full | Rivaroxaban-induced spontaneous hemothorax: a rare case report and literature review |
| title_fullStr | Rivaroxaban-induced spontaneous hemothorax: a rare case report and literature review |
| title_full_unstemmed | Rivaroxaban-induced spontaneous hemothorax: a rare case report and literature review |
| title_short | Rivaroxaban-induced spontaneous hemothorax: a rare case report and literature review |
| title_sort | rivaroxaban induced spontaneous hemothorax a rare case report and literature review |
| topic | rivaroxaban fluconazole spontaneous hemothorax drug–drug interaction case report |
| url | https://www.frontiersin.org/articles/10.3389/fmed.2025.1641092/full |
| work_keys_str_mv | AT xiaolongli rivaroxabaninducedspontaneoushemothoraxararecasereportandliteraturereview AT shuhaoxu rivaroxabaninducedspontaneoushemothoraxararecasereportandliteraturereview AT chunfangzeng rivaroxabaninducedspontaneoushemothoraxararecasereportandliteraturereview AT dinghan rivaroxabaninducedspontaneoushemothoraxararecasereportandliteraturereview AT xinwang rivaroxabaninducedspontaneoushemothoraxararecasereportandliteraturereview |