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Transient false-positive hepatobiliary scan associated with ceftriaxone therapy
M Lorberboym1, M Machado, N Glajchen
1Department of Radiology, Mount Sinai School of Medicine, New York, New York 10029, USA.
Clinical Nuclear Medicine
|January 1, 1996
Summary
Ceftriaxone can cause false-positive results in hepatobiliary scans, mimicking acute cholecystitis. Discontinuing the antibiotic can reverse these effects, resolving the pseudocholelithiasis.
Area of Science:
- Hepatobiliary Imaging
- Pharmacology
- Gastroenterology
Background:
- False-positive results in hepatobiliary imaging are rare.
- Ceftriaxone is an antibiotic commonly used for bacterial infections.
Observation:
- A 54-year-old woman developed symptoms of acute cholecystitis while on intravenous ceftriaxone for meningitis.
- Initial sonogram showed a gallstone, and a Tc-99m DISIDA hepatobiliary scan indicated cystic duct obstruction.
Findings:
- Discontinuation of ceftriaxone led to clinical improvement.
- A repeat hepatobiliary scan two weeks later was normal, indicating reversible pseudocholelithiasis.
- High doses and prolonged use of ceftriaxone may induce these findings.
Implications:
- Ceftriaxone can cause drug-induced pseudocholelithiasis and mimic acute cholecystitis.
- Discontinuation of ceftriaxone is recommended when acute cholecystitis symptoms coincide with positive hepatobiliary scans.
- This condition is typically benign and reversible upon drug cessation.