Cefepime-Induced Mixed Hepatocellular and Cholestatic Liver Injury: A Case Report
- PMID: 39659312
- PMCID: PMC11631161
- DOI: 10.7759/cureus.73393
Cefepime-Induced Mixed Hepatocellular and Cholestatic Liver Injury: A Case Report
Abstract
Drug-induced liver injury (DILI) presents significant diagnostic challenges, particularly in patients with multiple comorbidities. We report a case involving a 72-year-old female treated with cefepime for urosepsis, who developed markedly elevated liver enzymes after two weeks of therapy. After excluding other potential causes, including viral hepatitis, ischemia, and autoimmune hepatitis, cefepime-induced mixed pattern liver injury was determined to be the likely etiology of the elevated liver enzymes. This case underscores the importance of considering DILI in the differential diagnosis and emphasizes the necessity for vigilant monitoring and early recognition, particularly in elderly patients.
Keywords: cefepime; cholestatic injury; drug-induced liver injury (dili); hepatocellular injury; idiosyncratic.
Copyright © 2024, Toofantabrizi et al.
Conflict of interest statement
Human subjects: Consent for treatment and open access publication was obtained or waived by all participants in this study. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work.
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References
-
- Drug-induced liver injury. David S, Hamilton JP. https://pubmed.ncbi.nlm.nih.gov/21874146/ US Gastroenterol Hepatol Rev. 2010;6:73–80. - PMC - PubMed
-
- Drug-induced liver injury: an analysis of 461 incidences submitted to the Spanish registry over a 10-year period. Andrade RJ, Lucena MI, Fernández MC, et al. Gastroenterology. 2005;129:512–521. - PubMed
-
- Drug-induced liver injury in a Swedish University hospital out-patient hepatology clinic. De Valle MB, Av Klinteberg V, Alem N, Olsson R, Björnsson E. Aliment Pharmacol Ther. 2005;129:512–521. - PubMed
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