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Metronidazole, an Uncommon Cause of Dizziness and Ataxia in the Emergency Department: A Case Report
INTRODUCTION: Metronidazole, a nitroimidazole antibiotic, is a well-known antibacterial and antiprotozoal agent that is generally well tolerated without many serious side effects. Most adverse reactions affect the gastrointestinal or genitourinary system, but the central nervous system may also be a...
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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University of California Irvine, Department of Emergency Medicine publishing Western Journal of Emergency Medicine
2021
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Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8143839/ https://www.ncbi.nlm.nih.gov/pubmed/34437014 http://dx.doi.org/10.5811/cpcem.2021.3.52046 |
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author | Starrs, Mary E. Yenigun, Onur M. |
author_facet | Starrs, Mary E. Yenigun, Onur M. |
author_sort | Starrs, Mary E. |
collection | PubMed |
description | INTRODUCTION: Metronidazole, a nitroimidazole antibiotic, is a well-known antibacterial and antiprotozoal agent that is generally well tolerated without many serious side effects. Most adverse reactions affect the gastrointestinal or genitourinary system, but the central nervous system may also be afflicted. In addition to headache and dizziness, cerebellar dysfunction can occur with metronidazole use. CASE REPORT: We discuss the clinical presentation and imaging findings of metronidazole-induced encephalopathy in a 12-year-old male. The patient had a history of Crohn’s disease and chronic Clostridium difficile infection for which he had received metronidazole for approximately 75 days prior to arrival to a local emergency department (ED). He presented with five days of progressive vertigo, nausea, vomiting, and ataxia. Subsequent magnetic resonance imaging showed symmetric hyperintense dentate nuclei lesions, characteristic of metronidazole-induced encephalopathy. The patient’s symptoms improved rapidly after cessation of metronidazole, and his symptoms had completely resolved by discharge on hospital day two. CONCLUSION: Metronidazole-induced encephalopathy is a rare cause of vertigo and ataxia that can lead to permanent sequela if not identified and treated promptly. Thus, it is important for physicians to keep this diagnosis in mind when evaluating patients on metronidazole who present to the ED with new neurologic complaints. |
format | Online Article Text |
id | pubmed-8143839 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | University of California Irvine, Department of Emergency Medicine publishing Western Journal of Emergency Medicine |
record_format | MEDLINE/PubMed |
spelling | pubmed-81438392021-05-28 Metronidazole, an Uncommon Cause of Dizziness and Ataxia in the Emergency Department: A Case Report Starrs, Mary E. Yenigun, Onur M. Clin Pract Cases Emerg Med Case Report INTRODUCTION: Metronidazole, a nitroimidazole antibiotic, is a well-known antibacterial and antiprotozoal agent that is generally well tolerated without many serious side effects. Most adverse reactions affect the gastrointestinal or genitourinary system, but the central nervous system may also be afflicted. In addition to headache and dizziness, cerebellar dysfunction can occur with metronidazole use. CASE REPORT: We discuss the clinical presentation and imaging findings of metronidazole-induced encephalopathy in a 12-year-old male. The patient had a history of Crohn’s disease and chronic Clostridium difficile infection for which he had received metronidazole for approximately 75 days prior to arrival to a local emergency department (ED). He presented with five days of progressive vertigo, nausea, vomiting, and ataxia. Subsequent magnetic resonance imaging showed symmetric hyperintense dentate nuclei lesions, characteristic of metronidazole-induced encephalopathy. The patient’s symptoms improved rapidly after cessation of metronidazole, and his symptoms had completely resolved by discharge on hospital day two. CONCLUSION: Metronidazole-induced encephalopathy is a rare cause of vertigo and ataxia that can lead to permanent sequela if not identified and treated promptly. Thus, it is important for physicians to keep this diagnosis in mind when evaluating patients on metronidazole who present to the ED with new neurologic complaints. University of California Irvine, Department of Emergency Medicine publishing Western Journal of Emergency Medicine 2021-05-10 /pmc/articles/PMC8143839/ /pubmed/34437014 http://dx.doi.org/10.5811/cpcem.2021.3.52046 Text en Copyright: © 2021 Starrs et al. https://creativecommons.org/licenses/by/4.0/This is an open access article distributed in accordance with the terms of the Creative Commons Attribution (CC BY 4.0) License. See: http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) |
spellingShingle | Case Report Starrs, Mary E. Yenigun, Onur M. Metronidazole, an Uncommon Cause of Dizziness and Ataxia in the Emergency Department: A Case Report |
title | Metronidazole, an Uncommon Cause of Dizziness and Ataxia in the Emergency Department: A Case Report |
title_full | Metronidazole, an Uncommon Cause of Dizziness and Ataxia in the Emergency Department: A Case Report |
title_fullStr | Metronidazole, an Uncommon Cause of Dizziness and Ataxia in the Emergency Department: A Case Report |
title_full_unstemmed | Metronidazole, an Uncommon Cause of Dizziness and Ataxia in the Emergency Department: A Case Report |
title_short | Metronidazole, an Uncommon Cause of Dizziness and Ataxia in the Emergency Department: A Case Report |
title_sort | metronidazole, an uncommon cause of dizziness and ataxia in the emergency department: a case report |
topic | Case Report |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8143839/ https://www.ncbi.nlm.nih.gov/pubmed/34437014 http://dx.doi.org/10.5811/cpcem.2021.3.52046 |
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