Pediatric Infection and Vaccine

The Korean Society of Pediatric Infectious Diseases (대한소아감염학회)
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A Case of Ceftriaxone Associated Biliary Sludge

Ceftriaxone과 연관된 소아의 담도 오니(biliary sludge) 1례

  • Yoon, Jae Kyun (Department of Pediatrics, College of Medicine, Kwandong University) ;
  • Lee, Hyun Hee (Department of Pediatrics, College of Medicine, Kwandong University) ;
  • Shin, Young Kyoo (Department of Pediatrics, College of Medicine, Korea University) ;
  • Choung, Ji Tae (Department of Pediatrics, College of Medicine, Korea University) ;
  • Tockgo, Young Chang (Department of Pediatrics, College of Medicine, Korea University)
  • 윤재균 (관동대학교 의과대학 소아과학교실) ;
  • 이현희 (관동대학교 의과대학 소아과학교실) ;
  • 신영규 (고려대학교 의과대학 소아과학교실) ;
  • 정지태 (고려대학교 의과대학 소아과학교실) ;
  • 독고영창 (고려대학교 의과대학 소아과학교실)
  • Published : 1997.11.20
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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. A 6-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.

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