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Ceftriaxone-associated acute gallbladder enlargement - an unexpected diagnosis in the child with urinary tract

Grażyna Krzemień1, Tomasz Książczyk2, Agnieszka Szmigielska1

  • 1Department of Pediatrics and Nephrology, The Medical University of Warsaw, Poland.

Developmental Period Medicine
|September 19, 2015
PubMed

Insights

Ceftriaxone treatment can cause biliary sludge and pseudolithiasis, a usually asymptomatic complication. Monitoring is recommended for patients on this antibiotic to detect these gallbladder changes.

Area of Science:

  • Pediatric infectious diseases
  • Gastroenterology
  • Pharmacology

Background:

  • Ceftriaxone is a widely used antibiotic for various infections.
  • Biliary sludge and pseudolithiasis are known potential side effects of ceftriaxone treatment.
  • These complications typically occur in 3-57% of patients and are often asymptomatic.

Observation:

  • A case study involving a 5-month-old boy treated for acute pyelonephritis is presented.
  • Routine ultrasound revealed gallbladder enlargement on the 5th day of ceftriaxone therapy.
  • Subsequent ultrasounds showed the development of biliary sludge, with no clinical symptoms observed.

Findings:

  • The patient exhibited gallbladder enlargement and biliary sludge during ceftriaxone treatment.
  • These findings are consistent with known ceftriaxone-induced biliary complications.
  • The gallbladder abnormalities resolved completely six weeks after discontinuing the antibiotic.

Implications:

  • Healthcare providers should be aware of the potential for ceftriaxone-induced biliary sludge and pseudolithiasis.
  • Monitoring patients on ceftriaxone, particularly with prolonged use or in pediatric populations, may be warranted.
  • Early detection and discontinuation of the drug can lead to resolution of these biliary complications.
Abstract

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