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Ceftriaxone-associated gallbladder pseudolithiasis: report of one case

Hsiu-Huei Wen1, Yao-Kang Huang, Gui-Lin Zheng

  • 1Department of Pediatrics, Ten-Chan Hospital, Tao Yuan, Taiwan. service@tcmg.com.tw

Acta Paediatrica Taiwanica = Taiwan Er Ke Yi Xue Hui Za Zhi
|May 5, 2005
PubMed

Insights

Ceftriaxone can cause reversible gallbladder precipitates in children, a rare complication in Taiwan. This case highlights the importance of recognizing ceftriaxone-induced pseudolithiasis to avoid unnecessary surgeries.

Area of Science:

  • Pediatrics
  • Gastroenterology
  • Radiology

Background:

  • Ceftriaxone is a third-generation cephalosporin antibiotic commonly used for bacterial infections.
  • Gallbladder pseudolithiasis, or false gallstones, is a known but rarely reported side effect of ceftriaxone in children.
  • Taiwan has limited reported cases of this specific ceftriaxone complication in pediatric patients.

Observation:

  • A 5-year-old boy presented with severe Salmonella gastroenteritis requiring treatment with ceftriaxone due to multidrug resistance.
  • Gallbladder pseudolithiasis developed five days after the initiation of ceftriaxone therapy.
  • The pseudolithiasis resolved completely one month after cessation of the antibiotic treatment.

Findings:

  • This case report documents a rare instance of ceftriaxone-associated gallbladder pseudolithiasis in a pediatric patient in Taiwan.
  • The condition was reversible, resolving spontaneously after the discontinuation of ceftriaxone.
  • The clinical presentation mimicked true cholelithiasis, necessitating careful radiological interpretation.

Implications:

  • Pediatricians should maintain a high index of suspicion for ceftriaxone-induced pseudolithiasis in children presenting with gallbladder abnormalities during antibiotic therapy.
  • Radiologists must be aware of this potential adverse effect of ceftriaxone to avoid misdiagnosis and unnecessary invasive procedures.
  • Early recognition and understanding of this reversible condition can prevent patient anxiety and the avoidance of unnecessary cholecystectomy in pediatric patients.

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