Ceftriaxone-Associated Severe Acute Hepatitis

Abstract

Drug-induced liver injury (DILI) is a common entity. Ceftriaxone is a well-tolerated parenteral antibiotic widely used for various bacterial infections. We report a patient who developed severe acute hepatitis following a single dose of 2 g ceftriaxone within one day. Apart from a fever of 101.9 F, no other insult was noted to explain his severe hepatocellular injury around the time of presentation. On stopping further ceftriaxone, his symptoms resolved, and liver enzymes normalized within a week. His Roussel Uclaf Causality Assessment Method (RUCAM) score was 6 which suggested DILI be a probable cause of his acute hepatitis. Further surveillance at a larger scale is needed to support evidence for this rare side effect.

Keywords: ceftriaxone adverse effects; drug-induced liver injury (dili); elevated liver-associated enzymes; hepatitis; transaminitis.

Figure 1. CT abdomen with contrast showing situs inversus (blue double-headed arrow), fatty liver and no focal hepatic lesion (red arrow)