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NEUROIMAGE |
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Year : 2020 | Volume
: 68
| Issue : 2 | Page : 522-523 |
Fatal Metronidazole-Induced Encephalopathy
Jaechun Hwang, Mi-Yeon Eun
Department of Neurology, School of Medicine, Kyungpook National University, Kyungpook National University Chilgok Hospital, Daegu, Republic of Korea
Date of Web Publication | 15-May-2020 |
Correspondence Address: Mi-Yeon Eun Department of Neurology, School of Medicine, Kyungpook National University, Kyungpook National University Chilgok Hospital, 807 Hoguk-ro, Buk-gu, Daegu 41404 Republic of Korea
 Source of Support: None, Conflict of Interest: None  | Check |
DOI: 10.4103/0028-3886.284372
How to cite this article: Hwang J, Eun MY. Fatal Metronidazole-Induced Encephalopathy. Neurol India 2020;68:522-3 |
A 36-year-old man with acquired immune deficiency syndrome (AIDS) and anal cancer developed One week of slurred speech and disorientation followed by unconsciousness. He had been taking a three month of metronidazole (500 mg three times daily) for anal cancer-related infection. Diffusion-weighted magnetic resonance imaging revealed lesions for typical full-blown metronidazole-induced encephalopathy involving bilateral frontal cortex, subcortical white matter, putamen, corpus callosum, midbrain, pons, dorsal medulla, and cerebellar dentate nuclei [Figure 1].[1] He died despite three days of conservative treatment. Although it is usually reversible, metronidazole-induced encephalopathy can be fatal in immunocompromised patients with long-term use of metronidazole therapy.[2] | Figure 1: Diffusion-weighted MRI. Diffusion-weighted MRI revealed bilateral symmetric hyperintense lesions involving frontal cortex (a), subcortical white matter (b and c), putamen, corpus callosum (d), red nucleus, tegmentum, and tectum of midbrain (e), superior olivary nuclei and tegmentum of pons, dorsal medulla, and cerebellar dentate nuclei (f)
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Declaration of patient consent
The authors certify that they have obtained all appropriate patient consent forms. In the form the patient(s) has/have given his/her/their consent for his/her/their images and other clinical information to be reported in the journal. The patients understand that their names and initials will not be published and due efforts will be made to conceal their identity, but anonymity cannot be guaranteed.
Financial support and sponsorship
Nil.
Conflicts of interest
There are no conflicts of interest.
» References | |  |
1. | Kim E, Na DG, Kim EY, Kim JH, Son KR, Chang KH. MR imaging of metronidazole-induced encephalopathy: Lesion distribution and diffusion-weighted imaging findings. AJNR Am J Neuroradiol 2007;28:1652-8. |
2. | Kuriyama A, Jackson JL, Doi A, Kamiya T. Metronidazole-induced central nervous system toxicity: A systematic review. Clin Neuropharmacol 2011;34:241-7. |
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