You are here

Article Text

Article menu
Download PDFPDF
Case report
Metronidazole-induced reversible cerebellar dysfunction
  1. Kevin John John1,
  2. Deep P Pillai1,
  3. Vinod Pillai2 and
  4. John K John1
  1. 1Department of Neurology, Believers Church Medical College Hospital, Thiruvalla, Kerala, India
  2. 2Department of Gastrointestinal and Hepatobiliary Surgery, Believers Church Medical College Hospital, Thiruvalla, Kerala, India
  1. Correspondence to Dr John K John; johnkjohn101{at}gmail.com

Abstract

A 73-year-old man who presented with fever and abdominal discomfort was diagnosed to have a liver abscess. He was treated with antimicrobials which included metronidazole. One month into treatment, he developed neurological symptoms and signs that were suggestive of cerebellar pathology. MRI of the brain showed T2/fluid attenuated inversion recovery hyperintensities involving bilateral dentate, fastigial and interpositus nuclei. After excluding common aetiologies, the possibility of metronidazole-induced neurotoxicity was considered. After stopping metronidazole, his symptoms and signs resolved. A subsequent MRI scan of the brain showed reversal of changes. Neurotoxicity caused by metronidazole is an uncommon adverse effect of a commonly used antimicrobial drug and should be considered in the appropriate clinical scenario.

  • unwanted effects / adverse reactions
  • neuroimaging
  • drugs: CNS (not psychiatric)

https://doi.org/10.1136/bcr-2020-239227

Statistics from Altmetric.com

    Request Permissions

    If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.

    View Full Text

    Footnotes

    • Contributors KJJ conceived, designed and drafted the manuscript. DPP and VP were the consultants involved in patient care. Both DPP and JKJ reviewed the manuscript. JKJ was responsible for final approval of the manuscript prior to submission.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Patient consent for publication Obtained.

    • Provenance and peer review Not commissioned; externally peer reviewed.