Rapid Onset of Ceftriaxone-Induced Cholelithiasis in an Adult Patient
Bibliographic record
Abstract
Ceftriaxone is a third-generation cephalosporin with broad-spectrum antibacterial activity. Here, we report a case of ceftriaxone-induced cholelithiasis in an adult patient after a short period of administering ceftriaxone. A 57-year-old female was admitted to our hospital for meningitis and treated empirically with ceftriaxone 2 g every 12 hours. Other medications given included vancomycin, ampicillin and acyclovir. Based on culture results and a sensitivity report, ceftriaxone was continued while other medications were discontinued on day three after admission. Her liver function test (LFT) demonstrated an elevation in hepatic transaminases, and alanine and aspartate transaminases peaked on the fifth day (339 and 153 IU/L, respectively). Computed tomography (CT) and ultrasound (US) confirmed the presence of uncomplicated cholelithiasis. Ceftriaxone was discontinued and switched to cefotaxime 2 g every four hours. Hepatic transaminases started declining after ceftriaxone discontinuation and dropped to normal levels on day nine. After the administration of cefotaxime on the 25 th day, repeated US imaging revealed the persistence of biliary sludge. The patient was discharged in a good and stable clinical condition with follow-up planned at the outpatient clinic. When the concentration of ceftriaxone in the gallbladder exceeds the solubility of its calcium salt, precipitation occurs, forming a biliary sludge. Using the Naranjo Probability scale, the score was found to be 4, indicating a possible relationship between ceftriaxone and cholelithiasis. Multiple case reports of ceftriaxone-induced cholelithiasis have been documented previously, most of which focused on children or on the prolonged use of ceftriaxone. However, our case report highlights the development of cholelithiasis in adults after administering ceftriaxone for a short time.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".