Sasaki Osamu, Sugimura Kazunori, Shinoda Masahiro, Shinkai Masaharu
Division of Internal Medicine Tokyo-Shinagawa hospital Tokyo Japan.
J Gen Fam Med. 2019 Jul 12;20(5):209-212. doi: 10.1002/jgf2.269. eCollection 2019 Sep.
An 88-year-old woman with a history of meningioma and dementia was admitted with high fever, loss of appetite, and nausea in July. Urinary tract infection was suspected. Computed tomography (CT) showed no significant findings. Urinary findings improved with administration of ceftriaxone. However, high fever appeared on hospital day 28, and CT identified a gallbladder stone without any abdominal symptoms. We considered the possibility of ceftriaxone-associated pseudolithiasis and changed pharmacotherapy to cefmetazole. CT on day 34 showed a reduction in the size of the gallbladder stone. Ceftriaxone-associated pseudolithiasis might arise in the absence of abdominal symptoms, and clinicians should take the patient background and season into account when using this agent.
一名有脑膜瘤和痴呆病史的88岁女性于7月因高热、食欲不振和恶心入院。怀疑有尿路感染。计算机断层扫描(CT)未发现明显异常。使用头孢曲松治疗后尿液检查结果有所改善。然而,在住院第28天出现高热,CT检查发现胆囊结石,但无任何腹部症状。我们考虑了头孢曲松相关假性结石形成的可能性,并将药物治疗改为头孢美唑。第34天的CT显示胆囊结石尺寸减小。头孢曲松相关假性结石形成可能在无腹部症状的情况下出现,临床医生在使用该药物时应考虑患者背景和季节因素。