Vol.66 No.6 November 2018
Two cases of ceftriaxone-associated biliary pseudolithiasis in adults
1)Department of Surgery, Mori-cho National Health Insurance Hospital, 328 Uwadai-cho, Kayabe-gun, Hokkaido, Japan
2)Komatsu internal and cardiovascular medicine clinic
Abstract
Ceftriaxone(CTRX), a third-generation cephalosporin, is a widely used antimicrobial drug. Herein, we report two cases of a 78-year-old female and an 84-year-old male of ceftriaxone-associated biliary pseudolithiasis. Biliary pseudolithiasis were detected by abdominal CT 12 days after the administration of CTRX in one case and 11 days after administration of the drug in the other. Neither showed any abdominal symptoms or any liver function impairment associated with the pseudolithiasis, throughout the total clinical course. This complication generally resolves spontaneously with discontinuation of ceftriaxone. In one of our two cases, the pseudolithiasis resolved spontaneously on day 41 of admission, as determined by a repeat abdominal CT. Although, they may have sometimes symptomatically serious clinical problems. Some patients with pseudocholelithiasis present with symptoms of further complications, such as cholecystitis. Therefore, in patients receiving CTRX, it is important to discontinue the drug immediately in the event of appearance of any abdominal symptoms or evidence of liver function impairment, and promptly perform CT or ultrasonography(USG) to detect the possible presence of pseudocholelithiasis.
Key word
ceftriaxone, side effect, biliary pseudolithiasis
Received
February 26, 2018
Accepted
June 25, 2018
Jpn. J. Chemother. 66 (6): 762-765, 2018
