Metronidazole-Associated Peripheral Neuropathy in a Patient With End-Stage Renal Failure

Area of Science:

• Pharmacology
• Neurology
• Infectious Diseases

Background:

• Metronidazole is a broad-spectrum antimicrobial agent.
• Peripheral neuropathy is a known, albeit rare, adverse effect of metronidazole, with a reported incidence of 0.16% within 100 days.
• Serratia bacteremia and sepsis represent serious systemic infections.

Observation:

• A patient with end-stage renal failure developed peripheral neuropathy.
• The neuropathy was secondary to the use of metronidazole.
• The indication for metronidazole was treatment of Serratia bacteremia and sepsis.

Findings:

• This case presents a rare manifestation of metronidazole-induced peripheral neuropathy.
• The patient's underlying end-stage renal failure may have influenced the presentation or risk of neuropathy.
• The neurological complication occurred in the context of treating a severe bacterial infection.

Implications:

• Clinicians should be aware of the potential for metronidazole-associated peripheral neuropathy, even in complex patient populations.
• Monitoring for neurological symptoms is crucial in patients receiving prolonged or high-dose metronidazole, especially those with renal impairment.
• This case underscores the importance of considering drug-induced neurological toxicity in patients with sepsis and underlying comorbidities.