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Ceftriaxone-induced symptomatic pseudolithiasis mimicking ICP elevation.

C Evliyaoglu1, T Kizartici, G Bademci

  • 1Department of Neurosurgery, Kirikkale University School of Medicine, Kirikkale, Turkey. cevliyaoglu@hotmail.com

Zentralblatt Fur Neurochirurgie
|April 23, 2005
PubMed
Summary

Ceftriaxone, an antibiotic used in neurosurgery, can cause gallbladder precipitates mimicking intracranial pressure symptoms. Awareness of this biliary pseudolithiasis is crucial for accurate diagnosis in pediatric neurosurgery patients.

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Area of Science:

  • Neurosurgery
  • Pharmacology
  • Gastroenterology

Background:

  • Ceftriaxone is a third-generation cephalosporin frequently used in neurosurgery for central nervous system (CNS) infections and perioperative prophylaxis.
  • Antibiotic-induced complications require careful consideration in patient management.

Observation:

  • Recent studies indicate ceftriaxone can induce reversible precipitates in the gallbladder, a condition termed biliary pseudolithiasis.
  • Biliary pseudolithiasis presents with symptoms that can be mistaken for raised intracranial pressure (ICP).

Findings:

  • The symptoms of ceftriaxone-induced biliary pseudolithiasis overlap with critical postoperative neurosurgical symptoms, specifically those related to increased ICP.
  • This diagnostic challenge is particularly relevant in pediatric neurosurgery patients undergoing ceftriaxone therapy.

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Implications:

  • Recognizing biliary pseudolithiasis is essential to avoid misdiagnosis and unnecessary investigations or surgical interventions in pediatric neurosurgery.
  • Clinicians managing pediatric neurosurgery patients on ceftriaxone should consider this potential adverse effect to ensure appropriate patient care and timely diagnosis.