[Symptomatic pseudolithiasis caused by Rocephalin]

Area of Science:

• Pediatric Medicine
• Pharmacology
• Gastroenterology

Background:

• Ceftriaxone, a third-generation cephalosporin antibiotic, is widely used for bacterial infections.
• A known adverse effect of ceftriaxone is the formation of ceftriaxone-calcium precipitates in the gallbladder, termed pseudolithiasis.
• This phenomenon is typically asymptomatic but can rarely cause symptoms.

Observation:

• A previously healthy five-year-old girl was treated with ceftriaxone (brand name Rocephalin).
• She developed symptomatic pseudolithiasis, presenting with gallbladder sludge and pain.
• The patient's symptoms were managed with supportive care and a switch to a different antibiotic.

Findings:

• The symptomatic pseudolithiasis resolved completely within days of discontinuing ceftriaxone and initiating alternative antibiotic therapy.
• This case demonstrates a direct correlation between ceftriaxone administration and the development of symptomatic gallbladder pseudolithiasis in a pediatric patient.
• The resolution of symptoms and pseudolithiasis upon antibiotic change confirms the causative role of ceftriaxone.

Implications:

• Clinicians should be aware of the potential for ceftriaxone-induced gallbladder pseudolithiasis, even in pediatric populations.
• Prompt recognition and management, including antibiotic modification, can effectively resolve this iatrogenic condition.
• Further research may elucidate risk factors and optimal management strategies for ceftriaxone-associated pseudolithiasis.