Multiple hepatic pseudotumors: A rare presentation of hepatic steatosis.

A 39-year-old woman was suspected malignancy on computed tomography. The patient was finally diagnosed with multifocal nodular steatosis due to massive alcohol consumption. It is significant to consider hepatic steatosis as a possible differential diagnosis of multiple hypodense hepatic lesions and to take a careful history, which may lead to avoid unnecessary biopsies.

A Case of Alveolar Bleeding from Clotting Abnormality by Cefmetazole.

Cephalosporins are one of the most commonly used first-line antibiotics. In this report, we describe the case of a patient who developed alveolar bleeding due to clotting abnormality following the use of cefmetazole, one of cephalosporins containing an N-methylthiotetrazole (NMTT) side chain. Compared to other antibiotics, cephalosporins with an NMTT side chain cause a higher degree of bleeding events. The bleeding tendency is caused by the depletion of vitamin K-dependent clotting factors via inhibition of the vitamin K epoxide reductase. This mechanism of action is the same as warfarin. Recent years have seen an increase in the number of patients using direct oral anticoagulants that do not require coagulation tests. As a consequence, there may be an increase in the number of bleeding events due to anticoagulant drugs and such antibiotics coprescription. Therefore, this case is an instructive lesson.