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Metronidazole neuropathy: a case report.

H Takeuchi1, A Yamada, T Touge

  • 1Department of Internal Medicine, Kagawa Medical School, Japan.

The Japanese Journal of Psychiatry and Neurology
|June 1, 1988
PubMed
Summary
This summary is machine-generated.

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Metronidazole, an antibiotic for amebiasis, can cause peripheral neuropathy. This condition involves nerve damage, affecting sensory functions in a glove and stocking distribution.

Area of Science:

  • Neurology
  • Pharmacology
  • Toxicology

Background:

  • Metronidazole is a widely used antibiotic effective against anaerobic bacteria and protozoa.
  • Hepatic amebiasis is a serious condition requiring prompt treatment with effective antimicrobial agents.

Observation:

  • A 67-year-old male patient presented with peripheral neuropathy symptoms, including glove and stocking sensory disturbances.
  • These symptoms emerged after a high-dose course of metronidazole (101.25 g) for hepatic amebiasis.

Findings:

  • Sural nerve biopsy revealed a significant loss of myelinated fibers (2,400/mm2).
  • Unmyelinated fiber density was at the lower limit of normal (23,530/mm2).
  • Electron microscopy confirmed axonal degeneration in both myelinated and unmyelinated nerve fibers.

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Implications:

  • This case highlights a potential neurotoxic side effect of high-dose metronidazole therapy.
  • Metronidazole-induced neuropathy may present clinically similarly to myeloneuropathy.
  • Awareness of this adverse effect is crucial for clinicians managing patients on metronidazole.