Metronidazole-Induced Encephalopathy in a Patient with End-Stage Liver Disease
Joint Authors
Javed, Imran
Knorr, John P.
Sahni, Neha
Ortiz, Jorge A.
Cankurtaran, Ceylan Z.
Source
Issue
Vol. 2012, Issue 2012 (31 Dec. 2012), pp.1-4, 4 p.
Publisher
Hindawi Publishing Corporation
Publication Date
2012-12-17
Country of Publication
Egypt
No. of Pages
4
Main Subjects
Abstract EN
Purpose.
Metronidazole-induced encephalopathy (MIE) has been rarely reported.
We report a case in a patient with end-stage liver disease (ESLD).
Summary.
A 63-year-old male with ESLD secondary to hepatitis C virus presented with progressively worsening fatigue, slurred speech, aphasia, vomiting, and left-sided facial droop after completing a 2-week course of metronidazole for recurrent Clostridium difficile-associated diarrhea.
He completed a previous course of metronidazole 3 weeks prior to presentation.
He is on the liver transplant waiting list and has known hepatic encephalopathy.
MRI revealed hyperintense T2 signals involving the bilateral dentate nuclei, inferior colliculi and splenium of the corpus callosum, and increased diffusion restriction at the splenium of the corpus callosum.
His neurological function improved over the next several days.
He underwent liver transplantation 6 days after admission.
A follow-up MRI 6 weeks after presentation revealed resolution of abnormalities; however, paresthesias persisted 6 months after MIE diagnosis.
Conclusion.
An ESLD patient with hepatic encephalopathy developed MIE after a relatively short course of metronidazole.
Metronidazole has been shown to accumulate in patients with ESLD.
Increased awareness for neurotoxicity when using metronidazole in ESLD patients is warranted, especially in those with potentially confounding hepatic encephalopathy.
American Psychological Association (APA)
Knorr, John P.& Javed, Imran& Sahni, Neha& Cankurtaran, Ceylan Z.& Ortiz, Jorge A.. 2012. Metronidazole-Induced Encephalopathy in a Patient with End-Stage Liver Disease. Case Reports in Hepatology،Vol. 2012, no. 2012, pp.1-4.
https://search.emarefa.net/detail/BIM-454721
Modern Language Association (MLA)
Knorr, John P.…[et al.]. Metronidazole-Induced Encephalopathy in a Patient with End-Stage Liver Disease. Case Reports in Hepatology No. 2012 (2012), pp.1-4.
https://search.emarefa.net/detail/BIM-454721
American Medical Association (AMA)
Knorr, John P.& Javed, Imran& Sahni, Neha& Cankurtaran, Ceylan Z.& Ortiz, Jorge A.. Metronidazole-Induced Encephalopathy in a Patient with End-Stage Liver Disease. Case Reports in Hepatology. 2012. Vol. 2012, no. 2012, pp.1-4.
https://search.emarefa.net/detail/BIM-454721
Data Type
Journal Articles
Language
English
Notes
Includes bibliographical references
Record ID
BIM-454721