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CC BY-NC-ND 4.0 · Indian J Radiol Imaging 2019; 29(04): 431-434
DOI: 10.4103/ijri.IJRI_330_19
Case Report

Metronidazole induced encephalopathy: A rare side effect with a common drug

Venkatesh Vaithiyam
Departments of Medicine, All India Institute of Medical Sciences, New Delhi, India
,
Ranveer S Jadon
Departments of Medicine, All India Institute of Medical Sciences, New Delhi, India
,
Animesh Ray
Departments of Medicine, All India Institute of Medical Sciences, New Delhi, India
,
Smita Manchanda
Departments of Radiology, All India Institute of Medical Sciences, New Delhi, India
,
Ved P Meena
Departments of Medicine, All India Institute of Medical Sciences, New Delhi, India
,
Piyush Ranjan
Departments of Medicine, All India Institute of Medical Sciences, New Delhi, India
,
Naval K Vikram
Departments of Medicine, All India Institute of Medical Sciences, New Delhi, India
› Author Affiliations Financial support and sponsorship Nil.
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Abstract

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.

Keywords

Encephalopathy - metronidazole - seizure


Publication History

Received: 02 August 2019

Accepted: 23 October 2019

Article published online:
21 July 2021

© 2019. Indian Radiological Association. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).

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