Korean J Pediatr Infect Dis.  1997 Nov;4(2):308-313. 10.14776/kjpid.1997.4.2.308.

A Case of Ceftriaxone Associated Biliary Sludge

• Yoon JK
• Lee HH
• Shin YK
• Choung JT
• Tockgo YC

• KMID: 2440348
• DOI: http://doi.org/10.14776/kjpid.1997.4.2.308

Abstract

Ceftriaxone, an effective third generation cephalosporin with a wide range of antimicrobial activity, has become widely used by pediatricians for a variety of bacterial infections including meningitis. It has been associated with the development of sludge or stone in the gallbladder of some patients treated with this drug. Ceftriaxone associated biliary sludge has unusual acoustic characteristics and resembles gallstone. The sludge can cause symptoms such as cramping abdominal pain, and disappears after stopping ceftriaxone administration. Because of these seemingly confusing observations, it is important for the clinicians to recognize these findings that ceftriaxone treatment can cause. We report a case of ceftriaxone associated biliary sludge in Korean children.46-year-old girl who was treated for meningitis with ceftriaxone (100mg/kg/day) developed cramping upper abdominal pain from 5th hospital day. Physical examination, liver function tests and X-ray revealed no specific abnormal findings. But abdominal ultrasound revealed high amplitude echogenic sludge with prominent post-acoustic shadow in gallbladder and its diameter was 1.5cm. We stopped ceftriaxone administration and tried conservative care. Abdominal cramping pain subsided after 3 days of ceftriaxone removal. Second abdominal ultrasound confirmed the disappearance of sludge at 3 weeks later.

Keyword

Ceftriaxone; Biliary sludge; Child

MeSH Terms

Abdominal Pain
Acoustics
Bacterial Infections
Bile*
Ceftriaxone*
Child
Colic
Female
Gallbladder
Gallstones
Humans
Liver Function Tests
Meningitis
Muscle Cramp
Physical Examination
Sewage
Ultrasonography
Ceftriaxone
Sewage