[Encefalopathy as a side effect of metronidazole therapy – a case report]. 2017

Marina Karayianni, and Anders von Heijne, and Ann-Charlotte Laska
Danderyds Sjukhus AB - Internal medicin Stockholm, Sweden Danderyds Sjukhus AB - Internal medicin Stockholm, Sweden.

Encefalopathy as a side effect of metronidazole therapy - a case report  Neurological symptoms as side effects of pharmacological treatment generally tend to remain underdiagnosed. In this report, we present a case of a 79 year old patient that developed encephalopathy whilst undergoing prophylactic treatment with Metronidazole. The initial presentation of disseminated neurological symptoms lead to the suspicion of a cerebrovascular lesion. However, exacerbation of symptomatology with gait disturbance, ataxia and dysarthria challenged the preliminary diagnosis. Brain magnetic resonance imaging (MRI) demonstrated T2 hyper-intensity over bilateral dentate nuclei. A drug history revealed that the patient had been treated with Metronidazole daily for several weeks due to a surgical condition. Cessation of the drug provided reversal of symptoms and radiological findings upon follow up MRI. This case report aims at increasing awareness regarding side effects of Metronidazole as well as early detection in patients who present with neurological symptoms.

UI MeSH Term Description Entries
D008279 Magnetic Resonance Imaging Non-invasive method of demonstrating internal anatomy based on the principle that atomic nuclei in a strong magnetic field absorb pulses of radiofrequency energy and emit them as radiowaves which can be reconstructed into computerized images. The concept includes proton spin tomographic techniques. Chemical Shift Imaging,MR Tomography,MRI Scans,MRI, Functional,Magnetic Resonance Image,Magnetic Resonance Imaging, Functional,Magnetization Transfer Contrast Imaging,NMR Imaging,NMR Tomography,Tomography, NMR,Tomography, Proton Spin,fMRI,Functional Magnetic Resonance Imaging,Imaging, Chemical Shift,Proton Spin Tomography,Spin Echo Imaging,Steady-State Free Precession MRI,Tomography, MR,Zeugmatography,Chemical Shift Imagings,Echo Imaging, Spin,Echo Imagings, Spin,Functional MRI,Functional MRIs,Image, Magnetic Resonance,Imaging, Magnetic Resonance,Imaging, NMR,Imaging, Spin Echo,Imagings, Chemical Shift,Imagings, Spin Echo,MRI Scan,MRIs, Functional,Magnetic Resonance Images,Resonance Image, Magnetic,Scan, MRI,Scans, MRI,Shift Imaging, Chemical,Shift Imagings, Chemical,Spin Echo Imagings,Steady State Free Precession MRI
D008795 Metronidazole A nitroimidazole used to treat AMEBIASIS; VAGINITIS; TRICHOMONAS INFECTIONS; GIARDIASIS; ANAEROBIC BACTERIA; and TREPONEMAL INFECTIONS. 2-Methyl-5-nitroimidazole-1-ethanol,Bayer 5360,Clont,Danizol,Flagyl,Gineflavir,Metric,MetroGel,Metrodzhil,Metrogyl,Metronidazole Hydrochloride,Metronidazole Monohydrochloride,Metronidazole Phosphate,Metronidazole Phosphoester,Satric,Trichazol,Trichopol,Trivazol,Vagilen,2 Methyl 5 nitroimidazole 1 ethanol
D001927 Brain Diseases Pathologic conditions affecting the BRAIN, which is composed of the intracranial components of the CENTRAL NERVOUS SYSTEM. This includes (but is not limited to) the CEREBRAL CORTEX; intracranial white matter; BASAL GANGLIA; THALAMUS; HYPOTHALAMUS; BRAIN STEM; and CEREBELLUM. Intracranial Central Nervous System Disorders,Brain Disorders,CNS Disorders, Intracranial,Central Nervous System Disorders, Intracranial,Central Nervous System Intracranial Disorders,Encephalon Diseases,Encephalopathy,Intracranial CNS Disorders,Brain Disease,Brain Disorder,CNS Disorder, Intracranial,Encephalon Disease,Encephalopathies,Intracranial CNS Disorder
D004401 Dysarthria Disorders of speech articulation caused by imperfect coordination of pharynx, larynx, tongue, or face muscles. This may result from CRANIAL NERVE DISEASES; NEUROMUSCULAR DISEASES; CEREBELLAR DISEASES; BASAL GANGLIA DISEASES; BRAIN STEM diseases; or diseases of the corticobulbar tracts (see PYRAMIDAL TRACTS). The cortical language centers are intact in this condition. (From Adams et al., Principles of Neurology, 6th ed, p489) Hyperkinetic Dysarthria,Hypokinetic Dysarthria,Scanning Speech,Dysarthosis,Dysarthria, Flaccid,Dysarthria, Guttural,Dysarthria, Mixed,Dysarthria, Scanning,Dysarthria, Spastic,Dysarthoses,Dysarthria, Hyperkinetic,Dysarthria, Hypokinetic,Dysarthrias,Dysarthrias, Flaccid,Dysarthrias, Guttural,Dysarthrias, Hyperkinetic,Dysarthrias, Hypokinetic,Dysarthrias, Mixed,Dysarthrias, Scanning,Dysarthrias, Spastic,Flaccid Dysarthria,Flaccid Dysarthrias,Guttural Dysarthria,Guttural Dysarthrias,Hyperkinetic Dysarthrias,Hypokinetic Dysarthrias,Mixed Dysarthria,Mixed Dysarthrias,Scanning Dysarthria,Scanning Dysarthrias,Scanning Speechs,Spastic Dysarthria,Spastic Dysarthrias,Speechs, Scanning
D005260 Female Females
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000038 Abscess Accumulation of purulent material in tissues, organs, or circumscribed spaces, usually associated with signs of infection. Abscesses
D000368 Aged A person 65 years of age or older. For a person older than 79 years, AGED, 80 AND OVER is available. Elderly
D000890 Anti-Infective Agents Substances that prevent infectious agents or organisms from spreading or kill infectious agents in order to prevent the spread of infection. Anti-Infective Agent,Anti-Microbial Agent,Antimicrobial Agent,Microbicide,Microbicides,Anti-Microbial Agents,Antiinfective Agents,Antimicrobial Agents,Agent, Anti-Infective,Agent, Anti-Microbial,Agent, Antimicrobial,Agents, Anti-Infective,Agents, Anti-Microbial,Agents, Antiinfective,Agents, Antimicrobial,Anti Infective Agent,Anti Infective Agents,Anti Microbial Agent,Anti Microbial Agents
D001259 Ataxia Impairment of the ability to perform smoothly coordinated voluntary movements. This condition may affect the limbs, trunk, eyes, pharynx, larynx, and other structures. Ataxia may result from impaired sensory or motor function. Sensory ataxia may result from posterior column injury or PERIPHERAL NERVE DISEASES. Motor ataxia may be associated with CEREBELLAR DISEASES; CEREBRAL CORTEX diseases; THALAMIC DISEASES; BASAL GANGLIA DISEASES; injury to the RED NUCLEUS; and other conditions. Coordination Impairment,Dyssynergia,Incoordination,Ataxia, Appendicular,Ataxia, Limb,Ataxia, Motor,Ataxia, Sensory,Ataxia, Truncal,Ataxy,Dyscoordination,Lack of Coordination,Tremor, Rubral,Appendicular Ataxia,Appendicular Ataxias,Ataxias,Ataxias, Appendicular,Ataxias, Limb,Ataxias, Motor,Ataxias, Sensory,Ataxias, Truncal,Coordination Impairments,Coordination Lack,Impairment, Coordination,Impairments, Coordination,Incoordinations,Limb Ataxia,Limb Ataxias,Motor Ataxia,Motor Ataxias,Rubral Tremor,Rubral Tremors,Sensory Ataxia,Sensory Ataxias,Tremors, Rubral,Truncal Ataxia,Truncal Ataxias

Related Publications

Marina Karayianni, and Anders von Heijne, and Ann-Charlotte Laska
March 2010, Acta clinica Croatica,
Marina Karayianni, and Anders von Heijne, and Ann-Charlotte Laska
March 1996, Acta psychiatrica Scandinavica,
Marina Karayianni, and Anders von Heijne, and Ann-Charlotte Laska
October 1982, The American journal of psychiatry,
Marina Karayianni, and Anders von Heijne, and Ann-Charlotte Laska
February 2020, Oncology research,
Marina Karayianni, and Anders von Heijne, and Ann-Charlotte Laska
January 1986, Dermatosen in Beruf und Umwelt. Occupation and environment,
Marina Karayianni, and Anders von Heijne, and Ann-Charlotte Laska
January 2018, Emergency (Tehran, Iran),
Marina Karayianni, and Anders von Heijne, and Ann-Charlotte Laska
January 2020, Archives of academic emergency medicine,
Marina Karayianni, and Anders von Heijne, and Ann-Charlotte Laska
January 2003, The Turkish journal of pediatrics,
Marina Karayianni, and Anders von Heijne, and Ann-Charlotte Laska
November 2023, Cureus,
Marina Karayianni, and Anders von Heijne, and Ann-Charlotte Laska
February 1982, The American journal of psychiatry,
Copied contents to your clipboard!