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Ceftriaxone-Associated Severe Acute Hepatitis.

Muhammad Asif1, Wahab J Khan2, Sadia Aslam1

  • 1Internal Medicine, Avera McKennan Hospital and University Health Center, Sioux Falls, USA.

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|April 21, 2023
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Summary
This summary is machine-generated.

A single dose of ceftriaxone caused severe drug-induced liver injury (DILI) in a patient. Symptoms resolved after discontinuing the antibiotic, highlighting a rare but serious adverse effect.

Keywords:
ceftriaxone adverse effectsdrug-induced liver injury (dili)elevated liver-associated enzymeshepatitistransaminitis

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Area of Science:

  • Hepatology
  • Pharmacology
  • Infectious Diseases

Background:

  • Drug-induced liver injury (DILI) represents a significant clinical challenge.
  • Ceftriaxone is a commonly prescribed parenteral antibiotic known for its broad-spectrum activity and generally favorable safety profile.
  • Understanding potential rare adverse reactions is crucial for patient safety.

Observation:

  • A patient presented with severe acute hepatitis after receiving a single 2g dose of ceftriaxone.
  • The patient experienced fever (101.9 F) but had no other identifiable cause for the acute hepatocellular injury.
  • Clinical improvement and normalization of liver enzymes were observed within one week of ceasing ceftriaxone administration.

Findings:

  • The case suggests a probable link between a single ceftriaxone dose and severe acute hepatitis.
  • The Roussel Uclaf Causality Assessment Method (RUCAM) score of 6 indicated DILI as the likely cause.
  • This event underscores a rare potential side effect of ceftriaxone.

Implications:

  • This case highlights the importance of considering ceftriaxone as a potential cause of DILI, even after a single dose.
  • Further large-scale surveillance is warranted to establish the incidence and characteristics of this rare adverse effect.
  • Clinicians should maintain vigilance for potential hepatotoxicity when prescribing ceftriaxone, especially in cases of unexplained liver enzyme elevation.