title: Ceftriaxone-associated renal toxicity in adults: a case report and recommendations for the management of such cases.
abstract: OBJECTIVE
  Ceftriaxone is a third-generation cephalosporin with broad-spectrum antibacterial activity. Ceftriaxone-associated urolithiasis and post-renal acute renal failure (PARF) in adults is exceedingly rare and perhaps underappreciated. We report one such case to increase appreciation of this risk and provide recommendations for its management based on our experience and a review of other similar cases.
  
  
  METHODS
  A 25-year-old male suddenly developed colicky abdominal pain, anuria and bilateral renal colic during intravenous ceftriaxone administration. Investigations showed elevated serum creatinine,urinary tract ultrasound revealed bilateral mild hydronephrosis and proximal ureterectasia,abdominal enhanced computed tomography (CT) revealed that bilateral ureteropyelectasia and contrast medium failed to fill bilateral pelvises and ureters. This patient failed to respond to pharmacotherapy. Symptoms were resolved and renal function normalized following double J stent insertions by cystoscopy.
  
  
  CONCLUSIONS
  Overdose administration of ceftriaxone was related to urolithiasis and PARF in adults. MDCT and MIP were efficient and effective in identifying ceftriaxone-associated urolithiasis.Treatment should be optimized, including prompt J stent insertions by cystoscopy.
authors.affiliation: Department of Emergency Medicine, The Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China.
authors.forename: W
authors.initials: W
authors.lastname: Shen-Hua
authors.affiliation: Department of Orthopedics, Lanling People's Hospital, Lanling, Shandong Province, China.
authors.forename: M
authors.initials: M
authors.lastname: Fan-Yi
authors.affiliation: Department of Nephrology, The Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China.
authors.forename: Z
authors.initials: Z
authors.lastname: Qing-Ling
authors.affiliation: Department of Nephrology, Binjiang Branch Hospital, The Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China.
authors.forename: Z
authors.initials: Z
authors.lastname: Li-Na
authors.affiliation: Department of Nephrology, The Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China.
authors.forename: M
authors.initials: M
authors.lastname: Li-Jun
keywords: ceftriaxone; computed tomography; post-renal acute renal failure; urolithiasis