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Antimicrobial neurotoxicity: an under-recognised cause of delirium

D Moynan1, E Maqbool2, E de Barra1

  • 1Department of Infectious Diseases, Beaumont, Dublin.

Acute Medicine
|June 10, 2022
PubMed

Insights

Antimicrobial-associated encephalopathy (AAE) is a rare but serious adverse event from antibiotics. This case highlights a reversible encephalopathy with confusion and stupor in an elderly patient, emphasizing the need for physician awareness.

Area of Science:

  • Neurology
  • Infectious Diseases
  • Pharmacology

Background:

  • Antimicrobial-associated encephalopathy (AAE) is an under-recognized adverse event linked to antibiotic use.
  • Clinical symptoms of AAE are diverse, including myoclonus, seizures, and cerebellar signs, often dependent on the specific antimicrobial agent.

Observation:

  • A 76-year-old male patient presented with confusion, myoclonus, and stupor.
  • The patient was undergoing antimicrobial therapy for a peri-rectal abscess.

Findings:

  • The patient's symptoms indicated a reversible encephalopathy.
  • The presentation was directly associated with the prescribed antimicrobial treatment.

Implications:

  • Increased physician awareness of AAE is crucial due to its potential rarity in clinical practice.
  • Prompt recognition and discontinuation of the offending antimicrobial agent can lead to complete recovery.
  • This case underscores the importance of considering AAE in patients presenting with neurological changes during antibiotic therapy.

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