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ORIGINAL RESEARCH article

Front. Pediatr.
Sec. Pediatric Surgery
Volume 13 - 2025 | doi: 10.3389/fped.2025.1527014

Clinical Features and Outcomes of Pseudolithiasis Induced by Ceftriaxone in Chinese Children: A Single-Center Observational Study

Provisionally accepted
Chen Jin Chen Jin Wenli Xiu Wenli Xiu Yao Liu Yao Liu Xiwei Hao Xiwei Hao Qian Dong Qian Dong *
  • The Affiliated Hospital of Qingdao University, Qingdao, China

The final, formatted version of the article will be published soon.

    Introduction: Ceftriaxone (CTX) is widely used in pediatric infectious disease treatment, although the diagnostic and therapeutic management of CTX-induced gallbladder pseudolithiasis (PL) remains challenging. In this study, we investigated the occurrence, clinical features, and management of CTX-induced PL in children.A retrospective case-control study was conducted on 185 pediatric patients receiving CTX at a single center. Data on treatment regimens, gallbladder imaging findings, and serum biochemical parameters post-CTX therapy were analyzed. Patients were classified into PL (n = 34) and non-PL (n = 151) groups based on imaging findings.Results: PL was diagnosed in 18.4% of patients treated with CTX, primarily through ultrasound, which revealed hyperechoic material within the gallbladder. Compared with the non-PL group, patients with PL were older and taller, with no significant differences in CTX dosage (p = 0.915). Patients with PL also had higher rates of digestive and neurological infections (both p < 0.001). Serum analysis revealed distinct liver and kidney function markers in the PL group, including lower levels of total bile acids, adenosine deaminase, and lactate dehydrogenase, and higher creatinine levels (all p < 0.05). Discontinuation of CTX led to symptom resolution in most cases, and all cases of PL resolved within three months.The occurrence of PL is not significantly related to CTX dosage. Furthermore, the rate of CTX metabolism and excretion may play a key role in PL development. Overall, the findings demonstrate that ultrasound is an effective tool for monitoring the development of PL in children receiving CTX and that discontinuation of CTX could be an effective treatment for PL.

    Keywords: Ceftriaxone, Gallbladder pseudolithiasis, Pediatric infectious diseases, ultrasound imaging, Serum biomarkers

    Received: 12 Nov 2024; Accepted: 02 Jan 2025.

    Copyright: © 2025 Jin, Xiu, Liu, Hao and Dong. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Qian Dong, The Affiliated Hospital of Qingdao University, Qingdao, China

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.