Ceftriaxone-associated biliary pseudolithiasis; a case report

ABSTRACT

Biliary sludge or pseudolithiasis has been reported in patients who have received prolonged and/high doses of ceftriaxone. These are usually asymptomatic, but true bililary lithiasis is also rare. In general these adverse effects [sludge and pseudolithiasis] may develop even after seven to ten days of treatment that are usually asymptomatic. We report a six half-year old girl that was admitted to the hospital due to urinary tract infection. She had been treated with ceftriaxone for 14 days. She developed biliary colic due to biliary lithiasis after 14-days treatment. Ultrasonography has reported high level echo with posterior shadow in gallbladder [true biliary stone]. We recommend patients on prolonged and high doses of ceftriaxone and also those developing biliary colic should be considered for liver and gallbladder ultrasound and changes in antibiotic treatment if necessary