Open AccessMetronidazole induced encephalopathy: A rare side effect with a common drug
Author(s) -
Venkatesh Vaithiyam,
Ranveer Singh Jadon,
Ayush Goel,
Smita Manchanda,
Ved Prakash Meena,
Piyush Ranjan,
Naval K. Vikram
Publication year - 2019
Publication title -
indian journal of radiology and imaging - new series/indian journal of radiology and imaging/indian journal of radiology and imaging
Language(s) - English
Resource type - Journals
eISSN - 0971-3026
pISSN - 0970-2016
DOI - 10.4103/ijri.ijri_330_19
Subject(s) - medicine , metronidazole , etiology , toxic encephalopathy , encephalopathy , adverse effect , pediatrics , hepatic encephalopathy , side effect (computer science) , altered mental status , intensive care medicine , pathology , antibiotics , cirrhosis , computer science , microbiology and biotechnology , biology , programming language
In hospitals, seizures and encephalopathy are one of the common complications observed in critically ill patients. Drug intoxication, metabolic derangements, and anatomical abnormalities can cause altered mental status. We encountered an uncommon case with a diagnostic dilemma due to persistent encephalopathy, where metronidazole toxicity was an etiological factor. A 45-year-old male, who was admitted with the diagnosis of ruptured amoebic liver abscess. During the course of his management, he developed seizures and altered sensorium. After excluding other etiologies for in-hospital de novo seizure, a suspicion of metronidazole toxicity was considered. MRI brain was done which suggested the same. Metronidazole induced encephalopathy (MIE) is an uncommon adverse effect of treatment with metronidazole. Diagnosis is made by identifying specific radiological findings. It characteristically affects the cerebellum and subcortical structures. While the clinical and neuroimaging changes are usually reversible, persistent encephalopathy with poor outcomes may occur as seen in our case.