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A case of amoxicillin-induced hepatocellular liver injury with bile-duct damage

Ju Seung Kim1, Young Rock Jang, Ji Won Lee

  • 1Department of Internal Medicine, Gachon University Gil Hospital, Gachon University of Medicine and Science, Incheon, Korea.

The Korean Journal of Hepatology
|November 22, 2011
PubMed

Insights

Amoxicillin, a common antibiotic, can rarely cause liver injury. This case report details a patient who developed cholestatic hepatitis after amoxicillin treatment for actinomycosis, with symptoms resolving upon drug discontinuation.

Area of Science:

  • Hepatology
  • Pharmacology
  • Microbiology

Background:

  • Amoxicillin is a widely used antibiotic for bacterial infections.
  • Drug-induced liver injury (DILI) from amoxicillin is rare, with hepatitis and cholestasis being uncommon.
  • Abdominal actinomycosis is a chronic bacterial infection often treated with antibiotics.

Observation:

  • A 39-year-old woman with abdominal actinomycosis was treated with amoxicillin.
  • The patient presented with elevated liver enzymes, indicating hepatocellular and bile-duct injury.
  • This clinical presentation suggested a diagnosis of amoxicillin-induced liver injury.

Findings:

  • The patient was diagnosed with amoxicillin-induced cholestatic hepatitis.
  • Discontinuation of amoxicillin led to significant improvement in the patient's liver enzyme levels.
  • Symptoms resolved, and liver function returned to near-normal ranges after stopping the antibiotic.

Implications:

  • This case highlights a rare but serious adverse effect of amoxicillin.
  • It underscores the importance of considering drug-induced liver injury in patients on amoxicillin presenting with hepatitis.
  • Prompt recognition and drug withdrawal are crucial for managing amoxicillin-induced cholestatic hepatitis.

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