Complications of ceftriaxone-associated biliary pseudolithiasis and neprolithiasis: a case report

Cir Pediatr. 2020 Jul 1;33(3):149-152.
[Article in English, Spanish]

Abstract

Introduction: Ceftriaxone is a wide-spectrum antibiotic frequently used in pediatrics. Biliary pseudolithiasis is a well-known side-effect occurring in 15-57% of cases. However, nephrolithiasis is extremely infrequent, with very few related publications.

Case report: We present the case of a 9-year-old patient with ceftriaxone-treated complicated acute appendicitis who developed biliary pseudolithiasis and nephrolithiasis. During hospitalization, the patient presented with pseudolithiasis complications such as mild pancreatitis and bilateral ureterohydronephrosis with acute renal failure.

Remarks: Suspecting ceftriaxone-associated biliary pseudolithiasis and/or nephrolithiasis is key to achieve an early diagnosis and prevent complications such as those reported in this patient. Early discontinuation is essential as an initial treatment measure.

Introduccion: La ceftriaxona es un antibiótico de amplio espectro frecuentemente utilizado en pediatría. La pseudolitiasis vesicular es un efecto adverso bien conocido, que se presenta en un 15 a 57% de los casos. En cambio la litiasis renal es extremadamente infrecuente con muy pocas publicaciones al respecto.

Caso clinico: Se presenta el caso de un paciente de 9 años que, durante tratamiento con ceftriaxona por una apendicitis aguda complicada, desarrolla pseudolitiasis vesicular y urinaria. Durante la misma internación el paciente presenta una pancreatitis leve y una ureterohidronefrosis bilateral, con insuficiencia renal aguda, como complicaciones de las pseudolitiasis.

Comentarios: La sospecha de la formación de litiasis renal y/o vesicular asociada al uso de ceftriaxona es fundamental para un diagnóstico temprano y prevención de complicaciones como las reportadas en este paciente, siendo fundamental la suspensión precoz del fármaco como inicio del tratamiento.

Keywords: Ceftriaxone; Children; Gallstones; Nephrolithiasis.

Publication types

  • Case Reports

MeSH terms

  • Acute Kidney Injury / diagnosis
  • Acute Kidney Injury / etiology
  • Anti-Bacterial Agents / administration & dosage
  • Anti-Bacterial Agents / adverse effects*
  • Appendicitis / drug therapy
  • Ceftriaxone / administration & dosage
  • Ceftriaxone / adverse effects*
  • Child
  • Humans
  • Kidney Calculi / chemically induced*
  • Kidney Calculi / diagnosis
  • Male
  • Pancreatitis / diagnosis
  • Pancreatitis / etiology

Substances

  • Anti-Bacterial Agents
  • Ceftriaxone