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Azithromycin-Induced Liver Injury in Legionnaires' Disease

Krista M Wong1, Keivan Hosseinnejad1, Poornanand Palaparty2

  • 1Internal Medicine, St. Vincent Charity Medical Center, Cleveland, USA.

Cureus
|October 18, 2021
PubMed

Insights

Drug-induced liver injury (DILI) is a serious concern. This case highlights azithromycin

Area of Science:

  • Hepatology
  • Pharmacology
  • Infectious Diseases

Background:

  • Drug-induced liver injury (DILI) is a significant cause of acute liver failure.
  • Azithromycin, a widely used antibiotic, is rarely associated with liver injury, typically cholestatic.
  • Hepatocellular liver injury from azithromycin is infrequently reported.

Observation:

  • A 66-year-old male patient with no prior liver disease developed liver injury.
  • The patient was being treated for Legionnaires' disease with azithromycin.
  • The observed liver injury exhibited a direct hepatocellular pattern.

Findings:

  • Azithromycin was associated with a hepatocellular pattern of liver injury in this case.
  • This contrasts with the more commonly reported cholestatic injury associated with azithromycin.
  • The patient recovered following discontinuation of the antibiotic.

Implications:

  • This case underscores the potential for azithromycin to cause hepatocellular liver injury.
  • Prompt recognition and drug cessation are crucial for managing rare azithromycin-induced liver injury.
  • Clinicians should consider azithromycin as a potential cause of hepatocellular liver injury, even if rare.
Keywords:
antibioticsazithromycinceftriaxonecommunity acquired pneumoniadrug-induced liver injuryhepatocellular liver injuryhepatotoxicitylegionella infectionlegionnaires disease

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