Metronidazole-induced Neurotoxicity: Case Report
DOI:
https://doi.org/10.20453/rmh.v36i1.5459Keywords:
Metronidazole, Brain Diseases, Magnetic Resonance Imaging, ToxicityAbstract
Metronidazole-induced neurotoxicity is an uncommon but underestimated complication in patients with prolonged exposure. We present the case of a 67-year-old male who presented with ataxia and seizures after receiving metronidazole and ceftriaxone for 65 days. The brain MRI showed typical lesions in the dentate nucleus, mesencephalon, and corpus callosum. Clinical and radiographic improvements were observed after stopping the antimicrobial. This case report emphasizes the importance of considering this entity in the differential diagnosis of neurologic derangement during prolonged antibiotic therapy, identifies MRI as a key diagnostic tool, and increases awareness to minimize serious adverse effects.
Downloads
References
Bhattacharyya S, Darby RR, Raibagkar P, Gonzalez Castro LN, Berkowitz AL. Antibiotic-associated encephalopathy. Neurology. 2016;86(10):963-71. doi: 10.1212/WNL.0000000000002455
Leitsch D. A review on metronidazole: an old warhorse in antimicrobial chemotherapy. Parasitology. 2019;146(9):1167–78. doi: 10.1017/S0031182017002025
Sørensen CG, Karlsson WK, Amin FM, Lindelof M. Metronidazole-induced encephalopathy: a systematic review. J Neurol. 2020 Jan;267(1):1-13. doi: 10.1007/s00415-018-9147-6
Goolsby TA, Jakeman B, Gaynes RP. Clinical relevance of metronidazole and peripheral neuropathy: a systematic review of the literature. Int J Antimicrob Agents. 2018;51(3):319-325. doi: 10.1016/j.ijantimicag.2017.08.033
Hernández Ceruelos A, Romero-Quezada LC, Ruvalcaba Ledezma JC, López Contreras L. Therapeutic uses of metronidazole and its side effects: an update. Eur Rev Med Pharmacol Sci. 2019;23(1):397-401. doi: 10.26355/eurrev_201901_16788
Daneman N, Cheng Y, Gomes T, Guan J, Mamdani MM, Saxena FE, et al. Metronidazole-associated Neurologic Events: A Nested Case-control Study. Clin Infect Dis. 2021;72(12):2095-2100. doi: 10.1093/cid/ciaa395
Patel L, Batchala P, Almardawi R, Morales R, Raghavan P. Acute metronidazole-induced neurotoxicity: an update on MRI findings. Clin Radiol. 2020;75(3):202-208. doi: 10.1016/j.crad.2019.11.002
Roy U, Panwar A, Pandit A, Das SK, Joshi B. Clinical and Neuroradiological Spectrum of Metronidazole Induced Encephalopathy: Our Experience and the Review of Literature. J Clin Diagn Res. 2016;10(6):OE01-9. doi: 10.7860/JCDR/2016/19032.8054
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2025 Ramon Rolando Cámara-Reyes, Eddie G. Díaz-Carrión
This work is licensed under a Creative Commons Attribution 4.0 International License.
Authors assign their rights to the RMH so that may disseminate the article through the means at their disposal. The journal will provide forms of affidavit of authorship and authorization for the publication of the article, which shall be submitted with the manuscript. Authors retain the right to share, copy, distribute, perform and publicly communicate their article, or part of it, mentioning the original publication in the journal.
