Ceftriaxone-associated urinary tract and biliary pseudolithiasis in children: a case report and literature review

Objective To investigate the pathogenesis,clinical characteristics,diagnosis and treatment of Ceftriaxone-associated urinary tract and biliary pseudolithiasis in children.Methods A 6-year-old boy was treated in our hospital in March 2011.The initial diagnosis was acute suppurative tonsillitis.Ceftriaxone was administered intravenously at a dose of 3 g/d [ 117 mg/( kg · d) ]for three days.After that the boy complained of bilateral abdominal pain and nausea.Abdominal sonogram obtained after cessation of ceftriaxone treatment revealed urinary tract and gallbladder stone and hydronephrosis.After cessation of ceftriaxone treatment and intubation tube into the ureters by cystoscope,symptoms gradually disappeared and renal function recovered.Results After cessation of ceftriaxone treatment,symptoms gradually disappeared,with urinary tract CT scan normal after 10 days.Urinary tract and gallbladder sonograms were found to be normal 22 days after diagnosis without specific treatment.Followed up for 1 month,no recurrence of stone was observed.Conclusions Ceftriaxone-associated urinary tract and biliary pseudolithiasis in children is rare.These complications generally resolve spontaneously with cessation of the ceftriaxone therapy.Physicians should be aware of these complications so as to avoid unnecessary therapeutic procedures. Key words: Ceftriaxone-associated pseudolithiasis ;  Urinary tract ;  Biliary ;  Diagnosis ;  Therapy