Pseudolithiasis due to Ceftriaxone Treatment for Meningitis in Children: Report of 8 Cases

Araz, Nilgün Çöl; Okan, Vahap; Demırcı, Mustafa; Araz, Mustafa

doi:10.1620/tjem.211.285

Cited by 26 publications

(16 citation statements)

References 14 publications

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“…Kimura reported that stones appeared on day 30 after the end of 12 days of ceftriaxone administration [5]. Generally, spontaneous exclusion (or disappearance) of the stones occurs relatively quickly after stopping ceftriaxone administration, but the period varies from 2 days to 5 months after the discontinuation of ceftriaxone administration [3], [4], [5], [8], [10], [12], [13]. In an in vitro study, at doses of ceftriaxone greater than or equal to 2 g, precipitation of ceftriaxone could occur, and the development of ceftriaxone-induced biliary sludge could be because of poor solubility that occurs in patients receiving a high-dose treatment (greater than or equal to 2 g) [6].…”

Section: Discussionmentioning

confidence: 99%

A case of ceftriaxone-associated biliary pseudolithiasis in an elderly patient with renal dysfunction

Abe¹

2017

IDCases

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Prior literature suggests that ceftriaxone causes formation of gallbladder stones at a relatively high frequency, and when abdominal symptoms occur, prompt investigation of the gallbladder is required with institution of appropriate treatment. Aging, malnutrition, renal impairment, and sepsis are risk factors for pseudolithiasis, and prevention of these is important to suppress gallstone development.

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Section: Discussionmentioning

confidence: 99%

A case of ceftriaxone-associated biliary pseudolithiasis in an elderly patient with renal dysfunction

Abe¹

2017

IDCases

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“…Patients with ceftriaxone-associated gallstones were found more likely to undergo spontaneous resolution. The antibiotic ceftriaxone, which is concentrated in the bile after excretion, causes a reversible pseudolithiasis that can be seen in 17% to 40% of patients receiving the antibiotic after at least 4 days of treatment (6,22,26). Araz et al (26) showed spontaneous resolution of ceftriaxone-associated stones in all 7 patients within 1 month of cessation of ceftriaxone.…”

Section: Discussionmentioning

confidence: 99%

A retrospective review of children with gallstone: Single-center experience from Central Anatolia

Gökçe

Yıldırım²,

Erdoğan³

2014

Turk J Gastroenterol

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Background/Aims: To evaluate children with gallstone in respect to demographic features, type of presentation, predisposing risk factors, laboratory features, complications, and outcome. Materials and Methods: Overall, 124 children with sonographically diagnosed gallstone were stratified into group 1 (symptomatic) and group 2 (asymptomatic). The data on demographic features, predisposing risk factors, laboratory features, complications, and outcome were collected from medical charts and compared by using convenient statistical methods.Results: There were 76 (61%) children in group 1. Females were significantly older than males at the time of diagnosis (p=0.001). After adjusting for age and sex, asymptomatic presentation was associated with hemolytic anemia (r=346, <0.001) and being an oncologic patient (r=248, p=0.006). No risk factor was specifically associated with having a symptomatic presentation. Sixteen children (12.9%) developed complications: 14 (18.4%) in group 1 and 2 (4.2%) in group 2 (p=0.027). Gallstone resolution was detected in 20 (29.4%) and 10 children (23.3%) in groups 1 and 2, respectively (p=0.477). Resolution was observed in 43.8% of children with ceftriaxone-associated gallstone. The rate of resolution with ursodeoxycholic acid (UDCA) was similar to that observed with expectant management. Gallstone resolution was evident in 9 infants (50.0%) and was significantly higher than children over 2 years of age (21 out of 106 children, 19.8%) (p=0.006). The most important factor associated with gallstone resolution was to be an infant (<2 years of age) at the time of diagnosis (OR: 3.1; 95% CI: 1.1-8.8; p=0.034). Conclusion: Ceftriaxone-associated gallstones are most likely to resolve but do not always undergo spontaneous resolution. UDCA treatment seems to be ineffective. Young age is a favorable factor for gallstone resolution. The rate of complications in children with asymptomatic presentation is considerably low. Thus, clinical follow-up rather than surgical intervention is suggested in children with asymptomatic presentation and in infants.

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“…Third, the summer season might be a risk factor for ceftriaxone‐associated pseudolithiasis. A past report showed that high environmental temperatures may represent an important risk factor for pseudolithiasis in children. In Japan, high temperature is common throughout summer and may induce a loss of body fluids, promoting sludge formation.…”

Section: Discussionmentioning

confidence: 99%

Asymptomatic ceftriaxone‐associated pseudolithiasis

Sasaki

Sugimura

Shinoda

et al. 2019

J of Gen and Family Med

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An 88‐year‐old woman with a history of meningioma and dementia was admitted with high fever, loss of appetite, and nausea in July. Urinary tract infection was suspected. Computed tomography (CT) showed no significant findings. Urinary findings improved with administration of ceftriaxone. However, high fever appeared on hospital day 28, and CT identified a gallbladder stone without any abdominal symptoms. We considered the possibility of ceftriaxone‐associated pseudolithiasis and changed pharmacotherapy to cefmetazole. CT on day 34 showed a reduction in the size of the gallbladder stone. Ceftriaxone‐associated pseudolithiasis might arise in the absence of abdominal symptoms, and clinicians should take the patient background and season into account when using this agent.

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Pseudolithiasis due to Ceftriaxone Treatment for Meningitis in Children: Report of 8 Cases

Cited by 26 publications

References 14 publications

A case of ceftriaxone-associated biliary pseudolithiasis in an elderly patient with renal dysfunction

A case of ceftriaxone-associated biliary pseudolithiasis in an elderly patient with renal dysfunction

A retrospective review of children with gallstone: Single-center experience from Central Anatolia

Asymptomatic ceftriaxone‐associated pseudolithiasis

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