Drug-induced liver injury is a rare event. We report on a 15-year old girl de-veloping jaundice and a maculopapular rash with pruritus after oral cefuroxime therapy. Liver enzymes as well as total bilirubin and direct bilirubin were elevated. After eliminating other causes of hepatitis, cefuroxime-induced hepatocellular-cholestatic hepatitis with pancytopenia was diagnosed and cefuroxime therapy was stopped. The patient recovered quickly and was discharged without complications. The prognosis of this side-effect of cefuroxime is generally favourable; lethal courses are rare.
Cite this paper
Kunze, W. , Streidl, J. , Klemm, T. and Lutze, J. (2019). Cefuroxime-Induced Hepatocellular-Cholestatic Hepatitis with Pancytopenia. Open Access Library Journal, 6, e5036. doi: http://dx.doi.org/10.4236/oalib.1105036.
Hussaini, S.H. and Farrington, E.A. (2014) Idiosyncratic Drug-Induces Liver Injury: An Update on the 2007 Overview. Expert Opinion on Drug Safety, 13, 67-81. https://doi.org/10.1517/14740338.2013.828032
Udo, R., Tcherny-Lessenot, S., Brauer, R., et al. (2016) The Risk of Acute Liver Injury Associated with the Use of Antibi-otics—Evaluating Robustness of Results in the Pharmacoepidemiological Research on Outcomes of Therapeutics by the European Consortium (PROTECT) Project. Pharmaco-epidemiology and Drug Safety, 25, 47-55.
Ferrajolo, C., Verhamme, K.M., Trifirò, G., et al. (2017) Antibiotic-Induced Liver Injury in Paediatric Outpatients: A Case-Control Study in Primary Care Databases. Drug Safety, 40, 305-315. https://doi.org/10.1007/s40264-016-0493-y
Molleston, J.P., Fontana, R.J., Lopez, M.J., Kleiner, D.E., Gu, J. and Chalasani, N. (2011) Drug-Induced Liver Injury Network. Characteristics of Idiosyncratic Drug-Induced Liver Injury in Children: Results from the DILIN Prospective Study. Journal of Pediatric Gastroenterology and Nutrition, 53, 182-198. https://doi.org/10.1097/MPG.0b013e31821d6cfd
Chen, J. and Ahmad, J. (2008) Cefdinir-Induced Hepatotoxity: Potential Hazards of Inappropriate Antibiotic Use. Journal of General Internal Medicine, 23, 1914-1916. https://doi.org/10.1007/s11606-008-0758-y
Walker, A.S., Causey, M.W. and Sebesta, J.A. (2012) Cefacolin-Induced Neutropenia and Thrombocytopenia Following Trauma: A Case Report. Military Medicine, 177, 352-354. https://doi.org/10.7205/MILMED-D-11-00319
Bilici, A., Karaduman, M. and Cankir, Z. (2007) A Rare Case of Hepatitis Associated with Cefproziltherapy. Scandinavian Journal of Infectious Diseases, 39, 190-192. https://doi.org/10.1080/00365540600823235