[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"detail-sidebar-cat-0-en-105":3,"doc-detail-442848-en":59,"doc-seo-442848-105":80},{"code":4,"msg":5,"data":6},0,"success",[7,13,18,23,28,33,38,43,48,51,55],{"id":8,"doc_module":4,"doc_module_name":9,"category_name":10,"show_sort_weight":11,"slug":12},1,"Document","Story & Novel",90,"story-novel",{"id":14,"doc_module":4,"doc_module_name":9,"category_name":15,"show_sort_weight":16,"slug":17},2,"Literature",80,"literature",{"id":19,"doc_module":4,"doc_module_name":9,"category_name":20,"show_sort_weight":21,"slug":22},4,"Exam",70,"exam",{"id":24,"doc_module":4,"doc_module_name":9,"category_name":25,"show_sort_weight":26,"slug":27},5,"Comic",60,"comic",{"id":29,"doc_module":4,"doc_module_name":9,"category_name":30,"show_sort_weight":31,"slug":32},6,"Technology",50,"technology",{"id":34,"doc_module":4,"doc_module_name":9,"category_name":35,"show_sort_weight":36,"slug":37},7,"Healthcare",40,"healthcare",{"id":39,"doc_module":4,"doc_module_name":9,"category_name":40,"show_sort_weight":41,"slug":42},8,"Research & Report",30,"research-report",{"id":44,"doc_module":4,"doc_module_name":9,"category_name":45,"show_sort_weight":46,"slug":47},9,"Religion & Spirituality",20,"religion-spirituality",{"id":46,"doc_module":4,"doc_module_name":9,"category_name":49,"show_sort_weight":46,"slug":50},"World Cup","world-cup",{"id":52,"doc_module":4,"doc_module_name":9,"category_name":53,"show_sort_weight":52,"slug":54},10,"Lifestyle","lifestyle",{"id":56,"doc_module":4,"doc_module_name":9,"category_name":57,"show_sort_weight":24,"slug":58},19,"General","general",{"code":4,"msg":5,"data":60},{"doc_id":61,"user_id":62,"nickname":63,"user_avatar":64,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":66,"doc_content":67,"file_id":68,"file_url":69,"file_type":70,"file_size":71,"view_count":19,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":72,"language":73,"language_code":74,"site_id":75,"html_lang":74,"table_of_contents":76,"faqs":77,"seo_title":78,"seo_description":66,"update_tm":79,"read_time":39,"preview_page_count":4},442848,962090893677,"mieayamfan","https://ap-avatar.wpscdn.com/davatar_3d24733baf745e90a7e4bdd5f77d97b2","Doxycycline-Induced Gastrointestinal Injury for Potential Lyme Disease Exposure","Doxycycline is a widely used antibiotic for tick-borne illnesses and is well known for causing esophageal injury, while gastric injury remains less frequently documented. Reported cases of gastrointestinal bleeding are rare, and those that exist often involve biopsy-confirmed doxycycline-related injury. In a context of increasing doxycycline use, this case emphasizes recognizing the drug-specific injury pattern, supporting patient management, and describing characteristic histologic findings.","ACG CASE REPORTS JOURNAL   \nCASE REPORT | STOMACH  \nDoxycycline-Induced Gastrointestinal Injury for Potential Lyme Disease Exposure  \nSapana R. Gupta, MD 1 , Ryan Liu2 , Lindsey Channen, MD3 , Syed Quadri, MD4 , and Amanda Pressman, MD, FACG3  \n1 Department of Internal Medicine, Rhode Island Hospital, Brown University, Providence, RI 2Department of Biology, Brown University, Providence, RI  \n3Department of Gastroenterology, Rhode Island Hospital, Brown University, Providence, RI 4 Department of Pathology, Rhode Island Hospital, Brown University, Providence, RI  \nABSTRACT  \nDoxycycline is an antibiotic frequently used to treat tick-borne diseases. It is known to cause esophageal injury, although gastric injury is less often described. Few cases have been reported ofgastrointestinal bleeding secondaryto biopsy-proven doxycycline use. In the setting of widespread doxycyclineuse, it is important to recognize this drug-specific pattern ofinjury to guide appropriate patient management. This case demonstrates doxycycline-induced gastrointestinal injury and highlights characteristic histological findings.  \nKEYWORDS: babesiosis; Lyme disease; doxycycline; drug-induced bleeding; gastroenterology  \nABBREVIATIONS: ALT, alanine aminotransferase;AST, aspartate aminotransferase; ED, emergency department;H. pylori, Helicobacter pylori; IU/L, international units per liter; mEq/L, milliequivalents per liter; mg/dL, milligrams per deciliter; MMP-9, matrix metalloproteinase-9  \nINTRODUCTION  \nSeveral medications, such as nonsteroidal anti-inflammatory drugs, bisphosphonates, and antibiotics (including tetracyclines), are known to induce gastrointestinal injury. Esophagitisis commonly seen, although pill-induced gastric injury islesswell characterized. On endoscopy, these medications present with mild inflammatory changes to ulcerations or perforations.1 In this report, we describe a case of gastrointestinal bleeding from biopsy-proven doxycycline-induced gastric injury.  \nCASE REPORT  \nThe patient was a69-year-old man from India with no medical historywho presented to the emergency department(ED)with1week offever. He had traveled to Greece, Egypt, and Israel 4 months prior but had been at his baseline health status since then. He cut tall grass around his property 3 weeks earlier but checked for ticks afterward. He complained of headaches, body aches, skin hyperpigmentation, and lightheadedness, although he denied shortness ofbreath, cough, nausea, or diarrhea. Upon outpatient evaluation, he was started on levofloxacin and chloroquine for concern of malaria.  \nIn the ED, the patient had a fever of 39.8°C, heart rate of 82, blood pressure of 108/61, and oxygen saturation of 97% on room air. He denied alcohol, tobacco, or illicit drug use. A physical examination revealed scleral icterus. The abdomen was soft, nontender, and without palpable organomegaly. The skin was free of rash. Laboratory data were significant for creatinine 1.78 mg/dL (unknown baseline), aspartate aminotransferase 186 IU/L, alanine aminotransferase (ALT) 130 IU/L, total bilirubin 7.7 mg/dL, direct bilirubin 4.6 mg/dL, lactic acid 2.9 mEq/L, white blood cell count 7.9 3109/L, hemoglobin 10.9 g/dL, hematocrit 31.6%, and platelet of 76 3109/L. A blood smear showed intraerythrocytic parasitic ring forms and a tetrad, favoring the diagnosis of Babesiosis without excluding Plasmodium falciparum due to recent travel history. The patient was started on atovaquone and azithromycin, with the addition of doxycycline for potential Lyme exposure. Although serological testing for Lyme disease was performed upon ED presentation and returned negative, the infectious disease consult advised continuing doxycyclineforthe full treatment course due to the patient’s high risk of exposure.  \nACG Case Rep J 2026;13:e01946 . doi:10 . 14309/crj.0000000000001946. Published online: January 5, 2026 Correspondence: Sapana R. Gupta, MD ([sgupta6@lifespan.org](sgupta6@lifespan.org)) .  \nACG Case Reports [Journal /","cbCaii1sBVVwvQyL","https://ap.wps.com/l/cbCaii1sBVVwvQyL","pdf",385393,3,"English","en",105,"# Abstract\n# Introduction\n# Case Report\n# Discussion","[{\"question\":\"Why is doxycycline a concern for gastrointestinal injury?\",\"answer\":\"Doxycycline is known to cause esophageal injury, and this report highlights that it can also produce gastric injury leading to gastrointestinal bleeding with biopsy-proven findings.\"},{\"question\":\"What symptoms and lab abnormalities were notable in the case?\",\"answer\":\"The patient presented with fever and showed anemia and thrombocytopenia, along with elevated liver enzymes and bilirubin, followed by a significant hemoglobin drop associated with melena.\"},{\"question\":\"How was the patient managed after suspected doxycycline-induced injury?\",\"answer\":\"The patient received packed red blood cells, underwent upper endoscopy, and was treated with a proton pump inhibitor (40 mg twice daily) for at least 30 days, with improvement and stable discharge.\"}]","Doxycycline-Induced Gastrointestinal Injury for Potential Lyme Disease Exposure | PDF",1790701859,{"code":4,"msg":81,"data":82},"ok",{"site_id":75,"language":74,"slug":83,"title":65,"keywords":84,"description":66,"schema_data":85,"social_meta":138,"head_meta":140,"extra_data":142,"updated_unix":143},"doxycycline-induced-gastrointestinal-injury-for-potential-lyme-disease-exposure","",{"@graph":86,"@context":137},[87,100,120],{"@type":88,"itemListElement":89},"BreadcrumbList",[90,94,96,98],{"item":91,"name":92,"@type":93,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":95,"name":9,"@type":93,"position":14},"https://docshare.wps.com/document/",{"item":97,"name":35,"@type":93,"position":72},"https://docshare.wps.com/document/healthcare/",{"item":99,"name":65,"@type":93,"position":19},"https://docshare.wps.com/document/doxycycline-induced-gastrointestinal-injury-for-potential-lyme-disease-exposure/442848/",{"url":99,"name":65,"@type":101,"image":102,"author":107,"headline":65,"publisher":109,"fileFormat":112,"inLanguage":74,"description":66,"dateModified":113,"datePublished":114,"encodingFormat":112,"isAccessibleForFree":115,"interactionStatistic":116},"DigitalDocument",{"url":103,"@type":104,"width":105,"height":106},"https://docshare.wps.com/thumbnails/doxycycline-induced-gastrointestinal-injury-for-potential-lyme-disease-exposure/442848.png","ImageObject",300,407,{"name":63,"@type":108},"Person",{"url":91,"name":110,"@type":111},"DocShare","Organization","application/pdf","2026-11-03","2026-09-29",true,{"@type":117,"interactionType":118,"userInteractionCount":19},"InteractionCounter",{"@type":119},"ViewAction",{"@type":121,"mainEntity":122},"FAQPage",[123,129,133],{"name":124,"@type":125,"acceptedAnswer":126},"Why is doxycycline a concern for gastrointestinal injury?","Question",{"text":127,"@type":128},"Doxycycline is known to cause esophageal injury, and this report highlights that it can also produce gastric injury leading to gastrointestinal bleeding with biopsy-proven findings.","Answer",{"name":130,"@type":125,"acceptedAnswer":131},"What symptoms and lab abnormalities were notable in the case?",{"text":132,"@type":128},"The patient presented with fever and showed anemia and thrombocytopenia, along with elevated liver enzymes and bilirubin, followed by a significant hemoglobin drop associated with melena.",{"name":134,"@type":125,"acceptedAnswer":135},"How was the patient managed after suspected doxycycline-induced injury?",{"text":136,"@type":128},"The patient received packed red blood cells, underwent upper endoscopy, and was treated with a proton pump inhibitor (40 mg twice daily) for at least 30 days, with improvement and stable discharge.","https://schema.org",{"og:url":99,"og:type":139,"og:title":65,"og:site_name":110,"og:description":66},"article",{"robots":141,"canonical":99},"index,follow",{"doc_id":61,"site_id":75},1792171116]