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Metronidazole-induced encephalopathy in a patient with infectious colitis: a case report

Hoon Kim1, Young Woo Kim, Seoung Rim Kim

  • 1Department of Neurosurgery, Bucheon St Mary's Hospital, College of Medicine, Catholic University, Bucheon, Korea. jkw94@naver.com.

Journal of Medical Case Reports
|February 16, 2011
PubMed
Abstract

Insights

Metronidazole can cause rare neurological side effects like encephalopathy and cerebellar syndrome. This case shows these effects are reversible after stopping the antibiotic, highlighting the need for careful monitoring.

Area of Science:

  • Neurology
  • Pharmacology
  • Radiology

Background:

  • Encephalopathy is a rare adverse effect of antibiotics like metronidazole.
  • Metronidazole neurotoxicity has been previously studied, but incidence is unknown.
  • This report details a case of reversible cerebellar dysfunction linked to metronidazole.

Purpose of the Study:

  • To report a case of metronidazole-induced encephalopathy.
  • To highlight the reversibility of metronidazole-induced neurological symptoms.
  • To emphasize the importance of considering metronidazole toxicity in patients with neurological disorders.

Main Methods:

  • Case presentation of a 71-year-old man with infectious colitis treated with metronidazole.
  • Clinical observation of drowsiness and slow response after metronidazole administration.
  • Brain MRI (T2-weighted and FLAIR) to assess neurological changes.

Main Results:

  • Patient developed drowsiness and slow response after metronidazole treatment.
  • MRI revealed bilateral symmetric hyperintensities in the dentate nucleus, cerebellum, and corpus callosum.
  • Discontinuation of metronidazole led to resolution of cerebellar syndrome and MRI signal changes.

Conclusions:

  • Metronidazole can cause neurological side effects, including cerebellar syndrome and encephalopathy.
  • Metronidazole-induced encephalopathy is reversible upon drug cessation.
  • Clinicians should consider metronidazole toxicity in patients with new-onset neurological symptoms.

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