[Cholestatic icterus induced by the administration of fusidic acid in a cirrhotic patient].
BACKGROUND
Fucidic acid is an antibiotic essentially used to treat staphylococcal infections. Its chemical structure is very similar to that of bilary acids and hence implies competitive mechanisms between their elimination and metabolization.


METHODS
A patient with a past history of alcohol-induced cirrhosis was treated with fucidic acid for a Staphylococci aureus urinary infection. On day 2 of treatment a conjugate bilirubine icterus appeared. There was no argument to suggest a decompensation of the icterus. The icterus disappeared on suspension of fucidic acid.


CONCLUSIONS
The occurrence of an icterus in a cirrhotic patient may evoke decompensation of the hepatopathy and an extensive exploration must be made. A thorough survey of all drug administration must be made. Notably, the possibility of the occurrence of a connective bilirubin icterus during treatment with fucidic acid must be known. The icterus always regresses on withdrawal of treatment and this etiology must be evoked before conducting invasive examinations.
Carbonell
N
N
Service d'hépatologie, CHU Saint-Antoine, 75012 Paris. nicolas.carbonell@sat.ap-hop-paris.fr
Thabut
D
D
Podevin
P
P
Biour
M
M
Serfaty
L
L
Poupon
R
R
D000900:Anti-Bacterial Agents / Q000009:adverse effects* / Q000627:therapeutic use; D002779:Cholestasis / Q000139:chemically induced*; D005672:Fusidic Acid / Q000009:adverse effects* / Q000627:therapeutic use; D006801:Humans; D008103:Liver Cirrhosis / Q000150:complications*; D008297:Male; D008875:Middle Aged; D013203:Staphylococcal Infections / Q000188:drug therapy; D014552:Urinary Tract Infections / Q000188:drug therapy*
D000900:Anti-Bacterial Agents; D005672:Fusidic Acid