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[Headache, fever and upper abdominal colic]
J Binek1, D Herzog, K Bärlocher
1Departement für Innere Medizin, Kantonsspital St. Gallen.
Insights
Ceftriaxone, an antibiotic, can cause gallbladder sludge (pseudo-lithiasis) in nearly half of patients, sometimes leading to painful gallstones. These stones often resolve on their own after the antibiotic treatment stops.
Area of Science:
- Pediatric medicine
- Pharmacology
- Gastroenterology
Background:
- Ceftriaxone is a common antibiotic used to treat bacterial infections.
- Meningoencephalitis is a serious inflammation of the brain and its surrounding membranes.
Observation:
- A 9-year-old boy experienced right upper quadrant abdominal pain after a week of Ceftriaxone treatment for suspected bacterial meningoencephalitis.
- Gallstones were identified as the cause of the patient's abdominal symptoms.
Findings:
- Ceftriaxone treatment is associated with gallbladder pseudo-lithiasis in approximately 45% of patients.
- Clinical symptoms, such as abdominal pain, occurred in 19% of patients with Ceftriaxone-induced pseudo-lithiasis.
- The gallstones typically dissolve spontaneously after short-term Ceftriaxone therapy.
Implications:
- Physicians should be aware of the potential for Ceftriaxone to induce gallbladder sludge and subsequent symptoms.
- Monitoring for abdominal pain in patients treated with Ceftriaxone is advisable.
- Understanding this side effect can help prevent misdiagnosis and unnecessary interventions.
Abstract:
A nine year old boy who had received Ceftriaxone for one week because of suspected bacterial meningoencephalitis developed colicky abdominal pain in the right upper quadrant two days after termination of Ceftriaxone treatment. Stones in the gallbladder were identified as cause of the abdominal symptoms. Ceftriaxone has been reported to result in so-called pseudo-lithiasis of the gallbladder in approximatively 45% of treated patients, 19% of which developed clinical symptoms. Generally, the gallstones dissolve spontaneously when Ceftriaxone treatment was of short duration.