Ceftriaxone-associated cholelithiasis in a child with pneumococcal empyema

A previously well boy in middle childhood presented with a 2 week history of chesty cough, 1 week of fever, progressive respiratory distress and lethargy. Examination revealed reduced breath sounds over the right upper zone. Chest X-ray (CXR) revealed homogeneous right upper lobe consolidation ( figure 1). Empiric treatment was initiated with intravenous (IV) amoxicillin-clavulanic acid (60 mg/kg/day) and azithromycin (10 mg/kg/day).