Azithromycin-Induced Liver Injury in an Asthma Exacerbation Patient With Autoimmune Features.

Drug-induced liver injury (DILI) is one of the leading causes of acute liver failure in the United States. Antimicrobials are the most common class of drugs implicated in this pathology. Although azithromycin has been documented as a relatively safe drug, one of its rare and potentially fatal side effects is DILI. Diagnosing DILI is difficult because it is a diagnosis of exclusion. Autoimmune hepatitis (AIH) may present similarly to DILI, and a liver biopsy may be needed to differentiate between the two conditions. We present a case of azithromycin-induced liver injury in an asthma exacerbation patient with features of AIH.