Ceftriaxone-induced encephalopathy in a patient with a normal renal function.

Area of Science:

• Neurology
• Pharmacology
• Infectious Diseases

Background:

• Ceftriaxone is a widely used cephalosporin antibiotic.
• Ceftriaxone-induced encephalopathy is a rare adverse effect, typically seen in patients with renal impairment.
• Neurological symptoms associated with ceftriaxone can be severe and fluctuating.

Observation:

• A case of a fit elderly woman with normal renal function is presented.
• The patient developed aphasia, loss of contact, and chorea-like tongue movements during ceftriaxone treatment for a urinary tract infection with bacteremia.
• Symptoms emerged on day 4 and were suspected as an adverse drug reaction by day 7.

Findings:

• Ceftriaxone-induced encephalopathy was diagnosed after excluding other causes.
• Complete neurological recovery occurred within 3 days of ceftriaxone discontinuation.
• This case challenges the traditional risk factors associated with ceftriaxone encephalopathy.

Implications:

• Clinicians should consider ceftriaxone encephalopathy even in patients without renal failure.
• Early recognition and discontinuation of ceftriaxone are crucial for patient recovery.
• Further research into the pathophysiology and broader clinical spectrum of ceftriaxone-induced encephalopathy is warranted.