{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T16:28:03Z","timestamp":1789662483823,"version":"4.0.1"},"reference-count":14,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2022,5,18]],"date-time":"2022-05-18T00:00:00Z","timestamp":1652832000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2022,5,18]],"date-time":"2022-05-18T00:00:00Z","timestamp":1652832000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["surg case rep"],"published-print":{"date-parts":[[2022,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>Ceftriaxone, a third-generation cephalosporin antibiotic with a long plasma half-life, is widely used to treat various infections. The use of ceftriaxone can sometimes induce biliary sludge or stone formation. Although most cases of ceftriaxone-induced pseudolithiasis are asymptomatic or mild and resolve with discontinuation of the drug, we experienced an elderly case of severe acute necrotizing calculous cholecystitis after administration of ceftriaxone.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Case presentation<\/jats:title>\n                <jats:p>A 72-year-old male patient was admitted to our hospital because of acute diverticulitis in ascending colon. Ceftriaxone was administered at a dose of 2\u00a0g\/day for 6\u00a0days. Although he recovered after therapy, he was readmitted about 2\u00a0weeks later because of severe pain with rebound tenderness in the right upper quadrant. An abdominal imaging study revealed stones and sludge in the gallbladder that were not observed before starting ceftriaxone therapy. Therefore, antibiotic treatment with flomoxef 2\u00a0g\/day was indicated. However, on the fifth day of readmission, the peritoneal irritation symptoms in the right upper quadrant worsened, and elevated inflammatory response and liver dysfunction were observed. Cholecystectomy was performed based on these findings. The resected inflamed gallbladder showed acute necrotizing cholecystitis with sand granular gallstones. A comparative analysis of the infrared spectroscopic pattern of the composition of gallstones collected during surgery with that of the ceftriaxone powder revealed that both have very similar infrared spectroscopic patterns.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>Ceftriaxone-related pseudolithiasis is generally reversible and mainly observed in children. Here, we report a rare case of ceftriaxone-related acute necrotizing cholecystitis in an elderly patient. We confirmed that the stones in the gallbladder are composed of ceftriaxone. The older age, dehydration, fasting, and long-time bed rest during the administration of high-dose ceftriaxone were the potential risk factors for gallstone formation.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s40792-022-01450-5","type":"journal-article","created":{"date-parts":[[2022,5,18]],"date-time":"2022-05-18T02:03:39Z","timestamp":1652839419000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Acute necrotizing calculous cholecystitis after treatment with ceftriaxone in an elderly patient: a case report"],"prefix":"10.1186","volume":"8","author":[{"given":"Tsunehiko","family":"Shigemori","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ichiro","family":"Imoto","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yasuhiro","family":"Inoue","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ryo","family":"Nishiwaki","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Natsuko","family":"Sugimasa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tetsuya","family":"Hamaguchi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Midori","family":"Noji","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kenji","family":"Takeuchi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoshiyuki","family":"Ito","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Taro","family":"Yasuma","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5748-1499","authenticated-orcid":false,"given":"Esteban C.","family":"Gabazza","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Toshio","family":"Kato","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2022,5,18]]},"reference":[{"issue":"6","key":"1450_CR1","doi-asserted-by":"publisher","first-page":"708","DOI":"10.1097\/00006454-198611000-00026","volume":"5","author":"UB Schaad","year":"1986","unstructured":"Schaad UB, Tschappeler H, Lentze MJ. Transient formation of precipitations in the gallbladder associated with ceftriaxone therapy. Pediatr Infect Dis. 1986;5(6):708\u201310. https:\/\/doi.org\/10.1097\/00006454-198611000-00026.","journal-title":"Pediatr Infect Dis"},{"issue":"8625","key":"1450_CR2","doi-asserted-by":"publisher","first-page":"1411","DOI":"10.1016\/s0140-6736(88)90596-x","volume":"2","author":"UB Schaad","year":"1988","unstructured":"Schaad UB, Wedgwood-Krucko J, Tschaeppeler H. Reversible ceftriaxone-associated biliary pseudolithiasis in children. Lancet. 1988;2(8625):1411\u20133. https:\/\/doi.org\/10.1016\/s0140-6736(88)90596-x.","journal-title":"Lancet"},{"issue":"1","key":"1450_CR3","doi-asserted-by":"publisher","first-page":"40","DOI":"10.1111\/fcp.12577","volume":"35","author":"L Cuzzolin","year":"2021","unstructured":"Cuzzolin L, Oggiano AM, Clemente MG, Locci C, Antonucci L, Antonucci R. Ceftriaxone-associated biliary pseudolithiasis in children: do we know enough? Fundam Clin Pharmacol. 2021;35(1):40\u201352. https:\/\/doi.org\/10.1111\/fcp.12577.","journal-title":"Fundam Clin Pharmacol"},{"issue":"24","key":"1450_CR4","doi-asserted-by":"publisher","first-page":"3857","DOI":"10.2169\/internalmedicine.7611-21","volume":"60","author":"K Hotta","year":"2021","unstructured":"Hotta K, Hashimura N, Takatsuka M, Matsuyama T, Nakagawa K, Yabusako T, et al. Ceftriaxone-associated Pseudolithiasis in elderly people: frequency and risk factors. Intern Med. 2021;60(24):3857\u201364. https:\/\/doi.org\/10.2169\/internalmedicine.7611-21.","journal-title":"Intern Med"},{"issue":"3","key":"1450_CR5","first-page":"202","volume":"14","author":"G Famularo","year":"1999","unstructured":"Famularo G, Polchi S, De Simone C. Acute cholecystitis and pancreatitis in a patient with biliary sludge associated with the use of ceftriaxone: a rare but potentially severe complication. Ann Ital Med Int. 1999;14(3):202\u20134.","journal-title":"Ann Ital Med Int"},{"issue":"6","key":"1450_CR6","doi-asserted-by":"publisher","first-page":"562","DOI":"10.1007\/s00383-006-1656-1","volume":"22","author":"S Kim","year":"2006","unstructured":"Kim S, Gura KM, Puder M. Acute necrotizing cholecystitis: a rare complication of ceftriaxone-associated pseudolithiasis. Pediatr Surg Int. 2006;22(6):562\u20134. https:\/\/doi.org\/10.1007\/s00383-006-1656-1.","journal-title":"Pediatr Surg Int"},{"issue":"2 Pt 1","key":"1450_CR7","doi-asserted-by":"publisher","first-page":"246","DOI":"10.1016\/s0016-5107(94)70182-2","volume":"40","author":"E Lebovics","year":"1994","unstructured":"Lebovics E, Halata MS, Rosario JA, Lantin J, Schwarz SM, Rosenthal WS. Endoscopic management of ceftriaxone pseudolithiasis involving the common bile duct and gallbladder. Gastrointest Endosc. 1994;40(2 Pt 1):246\u20138. https:\/\/doi.org\/10.1016\/s0016-5107(94)70182-2.","journal-title":"Gastrointest Endosc"},{"issue":"5","key":"1450_CR8","doi-asserted-by":"publisher","first-page":"1077","DOI":"10.3919\/jjsa.79.1077","volume":"79","author":"T Murata","year":"2018","unstructured":"Murata T, Nishio K, Kitamura Y, Goto T, Sassaki K, Yano M. Laparoscopic cholecystectomy for biliary pseudolithiasis caused by ceftriaxone in an adult. Nihon Rinsho Geka Gakkai Zasshi. 2018;79(5):1077\u201382. https:\/\/doi.org\/10.3919\/jjsa.79.1077 (in Japanese).","journal-title":"Nihon Rinsho Geka Gakkai Zasshi"},{"issue":"6","key":"1450_CR9","doi-asserted-by":"publisher","first-page":"469","DOI":"10.2165\/00003495-198427060-00001","volume":"27","author":"DM Richards","year":"1984","unstructured":"Richards DM, Heel RC, Brogden RN, Speight TM, Avery GS. Ceftriaxone. A review of its antibacterial activity, pharmacological properties and therapeutic use. Drugs. 1984;27(6):469\u2013527. https:\/\/doi.org\/10.2165\/00003495-198427060-00001.","journal-title":"Drugs"},{"issue":"6","key":"1450_CR10","doi-asserted-by":"publisher","first-page":"1665","DOI":"10.1016\/0016-5085(91)90667-a","volume":"100","author":"HZ Park","year":"1991","unstructured":"Park HZ, Lee SP, Schy AL. Ceftriaxone-associated gallbladder sludge. Identification of calcium-ceftriaxone salt as a major component of gallbladder precipitate. Gastroenterology. 1991;100(6):1665\u201370. https:\/\/doi.org\/10.1016\/0016-5085(91)90667-a.","journal-title":"Gastroenterology"},{"issue":"2","key":"1450_CR11","doi-asserted-by":"publisher","first-page":"157","DOI":"10.1016\/j.jss.2004.05.020","volume":"122","author":"M Arpacik","year":"2004","unstructured":"Arpacik M, Ceran C, Kaya T, Karadas B, Sarac B, Koyluoglu G. Effects of ceftriaxone sodium on in vitro gallbladder contractility in guinea pigs. J Surg Res. 2004;122(2):157\u201361. https:\/\/doi.org\/10.1016\/j.jss.2004.05.020.","journal-title":"J Surg Res"},{"key":"1450_CR12","doi-asserted-by":"publisher","DOI":"10.1155\/2011\/730250","volume":"2011","author":"A Fretzayas","year":"2011","unstructured":"Fretzayas A, Liapi O, Papadopoulou A, Nicolaidou P, Stamoulakatou A. Is ceftriaxone-induced biliary pseudolithiasis influenced by UDP-glucuronosyltransferase 1A1 gene polymorphisms? Case Rep Med. 2011;2011: 730250. https:\/\/doi.org\/10.1155\/2011\/730250.","journal-title":"Case Rep Med"},{"issue":"5","key":"1450_CR13","doi-asserted-by":"publisher","first-page":"942","DOI":"10.1111\/ped.12625","volume":"57","author":"S Murata","year":"2015","unstructured":"Murata S, Aomatsu T, Yoden A, Tamai H. Fasting and bed rest, even for a relatively short period, are risk factors for ceftriaxone-associated pseudolithiasis. Pediatr Int. 2015;57(5):942\u20136. https:\/\/doi.org\/10.1111\/ped.12625.","journal-title":"Pediatr Int"},{"issue":"3","key":"1450_CR14","doi-asserted-by":"publisher","first-page":"613","DOI":"10.1007\/s10157-017-1493-7","volume":"22","author":"A Imafuku","year":"2018","unstructured":"Imafuku A, Sawa N, Sekine A, Kawada M, Hiramatsu R, Yamanouchi M, et al. Risk factors of ceftriaxone-associated biliary pseudolithiasis in adults: influence of renal dysfunction. Clin Exp Nephrol. 2018;22(3):613\u20139. https:\/\/doi.org\/10.1007\/s10157-017-1493-7.","journal-title":"Clin Exp Nephrol"}],"container-title":["Surgical Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s40792-022-01450-5.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s40792-022-01450-5\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s40792-022-01450-5.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,5,18]],"date-time":"2022-05-18T02:05:20Z","timestamp":1652839520000},"score":1,"resource":{"primary":{"URL":"https:\/\/surgicalcasereports.springeropen.com\/articles\/10.1186\/s40792-022-01450-5"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,5,18]]},"references-count":14,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2022,12]]}},"alternative-id":["1450"],"URL":"https:\/\/doi.org\/10.1186\/s40792-022-01450-5","relation":{},"ISSN":["2198-7793"],"issn-type":[{"value":"2198-7793","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,5,18]]},"assertion":[{"value":"5 March 2022","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"8 May 2022","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"18 May 2022","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Not applicable.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Written informed consent was obtained from the patient<b>.<\/b>","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declared no conflict of interest.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interest"}}],"article-number":"97"}}