In this case study, 36 h of ceftriaxone therapy the 9-year-old girl complained biliary colic with ultrasonography-proven biliary precipitates. We concluded that ceftriaxone-associated biliary pseudolithiasis can be observed within 2 days of starting ceftriaxone therapy. Dear Editor,
References
GALACTOSAEMIA PRESENTING AS BEDSIDE HYPERGLYCAEMIAWe would like to highlight a clinically significant but little known limitation of bedside glucometers. A male baby was presented to us at 5 weeks of age with failure to thrive. He had initially breastfed but changed to bottle formula feeds rapidly. He had an enlarged liver span on percussion. Bedside blood glucose testing with the accu-chek advantage II meter showed a concentration of 17.9 mmol/L. Urine dipstix was negative for glucose and ketones. A venous blood gas showed a pH of 7.37, bicarbonate 20.1 nmol/L and base excess −4 mEq/L. Laboratory measurement of blood glucose gave a concentration of 3 mmol/L. Urine-reducing substances were strongly positive, with urine glucose remaining negative. A provisional diagnosis of galactosaemia was made and a subsequent galactose-1-phosphate uridyl transferase level showed no enzyme activity, confirming the diagnosis. The baby was established on a soya-based formula and has begun to thrive.Bedside glucose testing meters have made possible immediate recognition of hypo-and hyperglycaemic states. The results obtained from such meters are affected by multiple factors and accuracy is lost at very high and very low blood glucose concentrations. Severe dehydration, hypotension and high haematocrit (>55%) may cause an underestimation of blood glucose concentration.