From Treatment to Toxicity: Metronidazole-Induced Encephalopathy in a 79-Year-Old Woman

Area of Science:

• Neurology
• Infectious Diseases
• Pharmacology

Background:

• Metronidazole is a key antibiotic for anaerobic and protozoal infections.
• Neurotoxic effects, including metronidazole-induced encephalopathy (MIE), are potential adverse events.
• Elderly patients and those with hepatic impairment are at higher risk for MIE.

Purpose of the Study:

• To report a case of metronidazole-induced encephalopathy (MIE) in an elderly patient.
• To highlight the importance of recognizing MIE in at-risk populations.
• To emphasize the need for careful monitoring during metronidazole therapy.

Main Methods:

• A case study of a 79-year-old woman with neurological symptoms after metronidazole treatment.
• Clinical assessment, MRI, and response to drug discontinuation were utilized.
• Diagnostic confirmation through symptom resolution post-metronidazole cessation.

Main Results:

• The patient developed altered mental status and cognitive decline attributed to MIE.
• MRI findings were consistent with metronidazole-induced encephalopathy.
• Discontinuation of metronidazole led to significant cognitive improvement.

Conclusions:

• Metronidazole-induced encephalopathy (MIE) is a critical diagnosis to consider in patients on metronidazole, especially the elderly.
• Prompt recognition and withdrawal of metronidazole are essential for neurological recovery.
• Healthcare providers must maintain high awareness of MIE to optimize patient outcomes.