title: Ceftriaxone-associated acute gallbladder enlargement - an unexpected diagnosis in the child with urinary tract infection.
abstract: Biliary sludge and/or biliary pseudolithiasis occur in patients treated with ceftriaxone with prevalence of 3-57%. Biliary obstruction can be the cause of the acute gallbladder enlargement. It is a minor complication, that usually does not give clinical symptoms and resolves once the drug is discontinued. The authors present a case of a 5-month old boy treated for the acute pyelonephritis. Routine ultrasound, performed on the 5th day of treatment with ceftriaxone, showed gallbladder enlargement. In the consecutive studies small gallblader sludge was visible. Patient had no symptoms related to the gallbladder enlargement. Ultrasound performed 6 weeks from the drug discontinuation was completely normal.
  
  
  CONCLUSIONS
  Patients treated with ceftroiaxone should be monitored for biliary sludge and pseudolithiasis.
authors.affiliation: Department of Pediatrics and Nephrology, The Medical University of Warsaw, Poland.
authors.forename: Grażyna
authors.initials: G
authors.lastname: Krzemień
authors.affiliation: Department of Pediatrics and Cardiology, The Medical University of Warsaw, Poland.
authors.forename: Tomasz
authors.initials: T
authors.lastname: Książczyk
authors.affiliation: Department of Pediatrics and Nephrology, The Medical University of Warsaw, Poland.
authors.forename: Agnieszka
authors.initials: A
authors.lastname: Szmigielska
authors.affiliation: Department of Pediatrics Radiology, The Medical University of Warsaw, Poland.
authors.forename: Przemysław
authors.initials: P
authors.lastname: Bombiński
authors.affiliation: Department of Pediatrics and Nephrology, The Medical University of Warsaw, Poland.
authors.forename: Maria
authors.initials: M
authors.lastname: Roszkowska-Blaim
authors.affiliation: Department of Pediatrics and Cardiology, The Medical University of Warsaw, Poland.
authors.forename: Bożena
authors.initials: B
authors.lastname: Werner
authors.affiliation: Department of Pediatrics Radiology, The Medical University of Warsaw, Poland.
authors.forename: Michał
authors.initials: M
authors.lastname: Brzewski
mesh_terms: D000900:Anti-Bacterial Agents / Q000009:adverse effects*; D001646:Bile / Q000000981:diagnostic imaging*; D002443:Ceftriaxone / Q000009:adverse effects*; D005705:Gallbladder Diseases / Q000139:chemically induced* / Q000000981:diagnostic imaging*; D006801:Humans; D007223:Infant; D008297:Male; D011704:Pyelonephritis / Q000150:complications / Q000188:drug therapy*; D014463:Ultrasonography; D014552:Urinary Tract Infections / Q000150:complications / Q000188:drug therapy*
chemical_list: D000900:Anti-Bacterial Agents; D002443:Ceftriaxone