A symptomatic child with ceftriaxone-associated biliary pseudolithiasis

Area of Science:

• Pediatric Gastroenterology
• Pharmacology
• Medical Imaging

Background:

• Ceftriaxone is a commonly used antibiotic in pediatric patients.
• Biliary pseudolithiasis is a rare adverse effect associated with certain medications.
• Pediatric abdominal pain can have various etiologies, requiring careful diagnostic evaluation.

Purpose of the Study:

• To report a case of ceftriaxone-associated biliary pseudolithiasis in a pediatric patient.
• To highlight the importance of recognizing this adverse drug reaction in children.
• To emphasize the role of ultrasonography in diagnosing biliary pseudolithiasis.

Main Methods:

• A case report of a 5-year-old boy treated with high-dose intravenous ceftriaxone for pneumonia.
• Clinical presentation of abdominal pain following antibiotic administration.
• Diagnostic imaging using abdominal sonography (ultrasound) to evaluate the gallbladder and biliary tree.
• Conservative management of symptoms and monitoring of gallbladder findings.

Main Results:

• The patient developed abdominal pain and was diagnosed with ceftriaxone-associated biliary pseudolithiasis.
• Abdominal sonograms revealed characteristic findings of biliary pseudolithiasis, including hyperechoic bands and sludge.
• Cessation of ceftriaxone therapy led to symptom resolution.
• Biliary findings normalized over time with conservative management.

Conclusions:

• Ceftriaxone, particularly at high doses in children, can induce biliary pseudolithiasis.
• Sonographers should be aware of this potential adverse effect when evaluating pediatric patients on ceftriaxone.
• Prompt recognition and drug discontinuation are key to managing ceftriaxone-induced biliary pseudolithiasis.