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Case Report of Metronidazole-Induced Encephalopathy

Adam Clements1

  • 1Aspirus Wausau Hospital, Wausau, Wisconsin, adam.clements@aspirus.org.

WMJ : Official Publication of the State Medical Society of Wisconsin
|January 23, 2018
PubMed

Insights

An 83-year-old woman developed metronidazole-induced encephalopathy, a rare condition causing reversible brain changes. Magnetic resonance imaging (MRI) confirmed the diagnosis, leading to prompt symptom resolution upon drug discontinuation.

Area of Science:

  • Neurology
  • Toxicology

Background:

  • Metronidazole is a commonly prescribed antibiotic for anaerobic bacterial infections.
  • Recurrent Clostridium difficile colitis often necessitates prolonged or repeated courses of metronidazole.

Observation:

  • An 83-year-old female patient presented with weakness and falls after multiple metronidazole treatments for Clostridium difficile colitis.
  • Magnetic resonance imaging (MRI) revealed T2 hyperintensities in the dorsal pons and dentate nuclei.

Findings:

  • The observed MRI findings were consistent with metronidazole-induced encephalopathy.
  • Discontinuation of metronidazole led to complete resolution of the patient's neurological symptoms.

Implications:

  • Metronidazole-induced encephalopathy is a rare but reversible neurological complication associated with this widely used antibiotic.
  • Further research is warranted to understand the pathophysiology and risk factors for metronidazole-induced encephalopathy, especially given its frequent clinical use.

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