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Listeria monocytogenes Infection of the Brain
05:02

Listeria monocytogenes Infection of the Brain

Published on: October 2, 2018

[Two cases of metronidazole-induced encephalopathy]

Kook Hyun Kim1, Jae Won Choi, Ji Yun Lee

  • 1Department of Internal Medicine, Yeungnam University College of Medicine, Daegu 705-717, Korea.

The Korean Journal of Gastroenterology = Taehan Sohwagi Hakhoe Chi
|March 22, 2005
PubMed

Insights

Metronidazole can cause neurologic side effects like encephalopathy, even in patients with liver issues. This study details two such cases diagnosed with advanced brain imaging, highlighting a previously unreported complication.

Area of Science:

  • Neurology
  • Pharmacology
  • Gastroenterology

Background:

  • Metronidazole, a 5-nitroimidazole antimicrobial, treats protozoal and anaerobic infections.
  • Neurologic side effects, including encephalopathy, are known adverse events associated with metronidazole use.
  • Metronidazole-induced encephalopathy (MIE) has been reported, but not specifically in patients with concurrent hepatic encephalopathy.

Observation:

  • Two cases of metronidazole-induced encephalopathy were observed in patients with liver cirrhosis secondary to chronic hepatitis B.
  • Diagnosis was confirmed using magnetic resonance imaging (MRI) and MR spectroscopy.
  • Follow-up imaging after metronidazole discontinuation was performed.

Findings:

  • The observed cases represent the first reported instances of metronidazole-induced encephalopathy in patients with hepatic encephalopathy.
  • Brain MRI and MR spectroscopy revealed characteristic changes associated with metronidazole toxicity.
  • Reversibility of imaging findings after drug cessation was noted.

Implications:

  • This study expands the understanding of metronidazole's potential neurotoxicity.
  • Highlights the importance of considering MIE in patients with liver disease presenting with neurologic symptoms.
  • Suggests the utility of advanced neuroimaging for diagnosing and monitoring MIE.

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