Acute cholestatic hepatitis linked to amoxicillin-clavulanic acid ; about a case report at the Regional University Hospital of Ouahigouya in Burkina Faso and review of the literature

Abstract

Drug-induced liver injury (DILI) is a major problem in modern hepatology. However, it remains underdiagnosed
and relatively rare. Antibiotics are the most frequently involved substances. We report a case of
acute hepatitis with amoxicillin-clavulanic acid in hospital at Ouahigouya (Burkina Faso). A 39-year-old
female working in a microfinance institution was hospitalized in August 2016 for a clinical cholestasis
syndrome after taking amoxicillin-clavulanic acid perioperatively from a dermoid ovarian cyst. In the
antecedents chapter: acute hepatitis documented to a medicinal plant, vernonia colorata in 2014, undocumented
jaundice after taking amoxicillin in 2013, no concept of alcohol consumption. The clinical examination
showed generalized jaundice, the biology revealed a syndrome of cholestasis, cytolysis and hepatocellular
insufficiency. Markers of viral hepatitis A, B, and C as well as those of autoimmunity were negative.
Hepatobiliary ultrasonography and other abdominal organs were normal. Therapeutically, and in front
of cholestasis the patient received ursodeoxycholic acid (Delursan r) 250 mg at the dosage of one (01) tablet
3 times daily. The evolution was favorable after 3 months with a normalization of clinical and biological
parameters. We report a documented case of cholestatic liver injury related to amoxicillin-clavulanic acid,
with a favorable evolution without re-exposure to the drug after 3 months.