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Cefepime-Induced Neurotoxicity Can Be Confused With Neuroleptic Malignant Syndrome, Catatonia and Serotonin Syndrome: A Case Report
Cefepime is a commonly used antibiotic. However, cefepime-induced neurotoxicity (CIN) is less commonly recognized. We describe a 75-year-old female on sertraline and risperidone who has been on cefepime for 28 days for treatment of osteomyelitis and presented with mutism, generalized rigidity, hyper...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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Cureus
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9960373/ https://www.ncbi.nlm.nih.gov/pubmed/36852358 http://dx.doi.org/10.7759/cureus.34223 |
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author | Abu-Abaa, Mohammad Bahadli, Dhay Abdulhussein, Osamah Abdulsahib, Ali Landau, Daniel |
author_facet | Abu-Abaa, Mohammad Bahadli, Dhay Abdulhussein, Osamah Abdulsahib, Ali Landau, Daniel |
author_sort | Abu-Abaa, Mohammad |
collection | PubMed |
description | Cefepime is a commonly used antibiotic. However, cefepime-induced neurotoxicity (CIN) is less commonly recognized. We describe a 75-year-old female on sertraline and risperidone who has been on cefepime for 28 days for treatment of osteomyelitis and presented with mutism, generalized rigidity, hyperreflexia, generalized stimulus-induced myoclonus, and reactive dilated pupils and found to have developed acute kidney injury. Although the diagnosis of serotonin syndrome (SS) and neuroleptic malignant syndrome (NMS) was suggested initially, the clinical picture was more compatible with CIN. Hemodialysis was suggested but gradual improvement in renal function allowed for gradual neurological recovery. This case highlights the importance of considering CIN in those who have been on Cefepime and present with altered mental status, especially in the appropriate clinical context and presence of risk factors. The overlap in clinical presentation between CIN, SS, NMS, and Catalonia may lead to a diagnostic challenge. Myoclonus seems to be characteristic of CIN and serves as a good clue to hint toward the diagnosis. This case helps to display the similarities and differences in the clinical presentation of these entities and therefore helps avoid confusion and prevents unnecessary therapeutic interventions. |
format | Online Article Text |
id | pubmed-9960373 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | Cureus |
record_format | MEDLINE/PubMed |
spelling | pubmed-99603732023-02-26 Cefepime-Induced Neurotoxicity Can Be Confused With Neuroleptic Malignant Syndrome, Catatonia and Serotonin Syndrome: A Case Report Abu-Abaa, Mohammad Bahadli, Dhay Abdulhussein, Osamah Abdulsahib, Ali Landau, Daniel Cureus Neurology Cefepime is a commonly used antibiotic. However, cefepime-induced neurotoxicity (CIN) is less commonly recognized. We describe a 75-year-old female on sertraline and risperidone who has been on cefepime for 28 days for treatment of osteomyelitis and presented with mutism, generalized rigidity, hyperreflexia, generalized stimulus-induced myoclonus, and reactive dilated pupils and found to have developed acute kidney injury. Although the diagnosis of serotonin syndrome (SS) and neuroleptic malignant syndrome (NMS) was suggested initially, the clinical picture was more compatible with CIN. Hemodialysis was suggested but gradual improvement in renal function allowed for gradual neurological recovery. This case highlights the importance of considering CIN in those who have been on Cefepime and present with altered mental status, especially in the appropriate clinical context and presence of risk factors. The overlap in clinical presentation between CIN, SS, NMS, and Catalonia may lead to a diagnostic challenge. Myoclonus seems to be characteristic of CIN and serves as a good clue to hint toward the diagnosis. This case helps to display the similarities and differences in the clinical presentation of these entities and therefore helps avoid confusion and prevents unnecessary therapeutic interventions. Cureus 2023-01-26 /pmc/articles/PMC9960373/ /pubmed/36852358 http://dx.doi.org/10.7759/cureus.34223 Text en Copyright © 2023, Abu-Abaa et al. https://creativecommons.org/licenses/by/3.0/This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. |
spellingShingle | Neurology Abu-Abaa, Mohammad Bahadli, Dhay Abdulhussein, Osamah Abdulsahib, Ali Landau, Daniel Cefepime-Induced Neurotoxicity Can Be Confused With Neuroleptic Malignant Syndrome, Catatonia and Serotonin Syndrome: A Case Report |
title | Cefepime-Induced Neurotoxicity Can Be Confused With Neuroleptic Malignant Syndrome, Catatonia and Serotonin Syndrome: A Case Report |
title_full | Cefepime-Induced Neurotoxicity Can Be Confused With Neuroleptic Malignant Syndrome, Catatonia and Serotonin Syndrome: A Case Report |
title_fullStr | Cefepime-Induced Neurotoxicity Can Be Confused With Neuroleptic Malignant Syndrome, Catatonia and Serotonin Syndrome: A Case Report |
title_full_unstemmed | Cefepime-Induced Neurotoxicity Can Be Confused With Neuroleptic Malignant Syndrome, Catatonia and Serotonin Syndrome: A Case Report |
title_short | Cefepime-Induced Neurotoxicity Can Be Confused With Neuroleptic Malignant Syndrome, Catatonia and Serotonin Syndrome: A Case Report |
title_sort | cefepime-induced neurotoxicity can be confused with neuroleptic malignant syndrome, catatonia and serotonin syndrome: a case report |
topic | Neurology |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9960373/ https://www.ncbi.nlm.nih.gov/pubmed/36852358 http://dx.doi.org/10.7759/cureus.34223 |
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