Delayed and prolonged cholestatic hepatitis with ductopenia after long-term ciprofloxacin therapy for Crohnʹs disease

Ciprofloxacin, a fluorinated quinolone, is a powerful antibiotic widely used for its broad spectrum of activity in ambulatory and long-term care setting. Until now, ciprofloxacin administration has been associated with a few cases of acute, sometimes cholestatic jaundice or fulminant hepatic failure believed mainly related to idiosyncratic hypersensitivity. We report a case of delayed and prolonged cholestatic hepatitis with ductopenia occurring after 6 months of treatment in a patient with Crohnʹs disease. This observation suggests the potential for the drug to induce long-term likely dose-related severe hepatotoxicity.