Metronidazole-induced cerebellar dysfunction: An underdiagnosed identity

Area of Science:

• Neurology
• Infectious Diseases
• Pharmacology

Background:

• Metronidazole is a widely prescribed antibiotic for various infections.
• Prolonged or high-dose use of metronidazole is linked to potential neurological toxicity.
• Amoebic liver abscesses often require extended treatment courses.

Observation:

• A patient treated for an amoebic liver abscess with metronidazole for seven weeks developed neurological complications.
• The patient exhibited symptoms of cerebellar dysfunction and small fiber peripheral neuropathy.
• Magnetic resonance imaging (MRI) revealed characteristic findings consistent with drug-induced toxicity.

Findings:

• The observed neurological symptoms were temporally associated with metronidazole administration.
• Cessation of metronidazole led to the resolution of the patient's symptoms.
• This case confirms metronidazole-induced cerebellar dysfunction and peripheral neuropathy.

Implications:

• Clinicians should exercise caution regarding the duration of metronidazole therapy.
• Consideration of alternative treatments, such as percutaneous drainage, is recommended for non-resolving amoebic liver abscesses.
• Awareness of metronidazole's neurotoxic potential is crucial for patient safety.