Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2023 Nov 3;10(12):004119.
doi: 10.12890/2023_004119. eCollection 2023.

Bismuth Subcitrate, Metronidazole and Tetracycline - A Rare Cause of Drug-Induced Liver Injury

Carina Silva  1 , Susana Merim  1 , Rita Sevivas  1 , João Mota  1 , Alexandra Leitão  1
Affiliations

Bismuth Subcitrate, Metronidazole and Tetracycline - A Rare Cause of Drug-Induced Liver Injury

Carina Silva et al. Eur J Case Rep Intern Med. .

Abstract

Drug-induced liver injury (DILI) is a liver condition caused by any drug or toxic substance. The spectrum of DILI manifestations can range from asymptomatic elevation of liver enzymes to acute liver failure. Antibiotics are one of the major causes of DILI. The authors report the case of a 37-year-old male with nausea, right hypochondrium pain and fever with history of bismuth subcitrate, metronidazole and tetracycline combination treatment in the previous five days. DILI was suspected and other aetiologies of acute hepatitis were excluded such as viral, autoimmune or even haemochromatosis and Wilson's disease. Liver biopsy was performed, being compatible with the diagnosis of DILI; DILI is a diagnosis of exclusion. Bismuth subcitrate, metronidazole and tetracycline combination treatment is a rare cause of DILI.

Learning points: Bismuth subcitrate, metronidazole and tetracycline in combination is a rare cause of drug-induced liver injury (DILI).DILI is an exclusion diagnosis.Liver biopsy has an important role in the diagnosis of DILI.

Keywords: Bismuth subcitrate; drug-induced liver injury; metronidazole; tetracycline.

PubMed Disclaimer

Conflict of interest statement

Conflicts of Interests: The Authors declare that there are no competing interests.

Similar articles

See all similar articles

References

    1. Katarey D, Verma S. Drug-induced liver injury. Clin Med (Lond) 2016;16(Suppl 6):s104–s109. - PMC - PubMed
    1. Nunes DRdCMA, Breton MC, Monteiro CSdJ, dos Santos JL. Drug induced liver injury: perspective of the adverse drug reaction reports to the Portuguese Pharmacovigilance System from 2010 to 2019. Healthcare (Basel) 2021;9:1630. - PMC - PubMed
    1. Hoofnagle JH, Björnsson ES. Drug-induced liver injury–types and phenotypes. N Engl J Med. 2019;381:264–273. - PubMed
    1. Malfertheiner P, Megraud F, Rokkas T, Gisbert JP, Liou J-M, Schulz C, et al. Management of Helicobacter pylori infection: the Maastricht VI/Florence consensus report. Gut. 2022;71:1724–1762.
    1. Shi X, Lao D, Xu Q, Li X, Lv Q. A case report of drug-induced liver injury after tigecycline administration: histopathological evidence and a probable causality grading as assessed by the updated RUCAM diagnostic scale. BMC Infect Dis. 2022;22:368. - PMC - PubMed

LinkOut - more resources