阿奇霉素致肝损害并发急性胆囊炎

An 81-year-old man was attacked by "sinusitis"and treated with azithromycin 500mg daily one week prior to admission. He felt upper abdominal discomfort and anorexia after taking the medication. It was considered the common side effects associated with azithromycin. The agent was still taken and the symptoms worsened progressively. Afterward, the man developed fever, dark urine and yellow skin. Physical examination revealed a temperature of 38℃,jaundice,tenderness and percussion pain on right upper abdomen and positive Murphy sign. WBC count was 11.4x109/L. Ultrasound showed gall bladder of 5.2x11.2cm. He was diagnosed as drug-induced hepatic damage and acute cholecystitis. His symptoms achieved complete remission after withdrawal of the medication and treatment of impaired liver function and inflammation.