Metronidazole-induced encephalopathy in a patient with spondylodiscitis.

IF 3 3区 医学 Q2 TOXICOLOGY
Clinical Toxicology Pub Date : 2024-09-01 Epub Date: 2024-08-07 DOI:10.1080/15563650.2024.2385683
Guilherme Martins, Ângelo Dias, Carla Guerreiro
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引用次数: 0

Abstract

Introduction: Metronidazole-induced encephalopathy is an uncommon but potentially severe complication of metronidazole treatment. Although the exact pathophysiology remains elusive, proposed hypotheses include RNA binding, neurotoxicity from free radicals, and modulation of neurotransmitter receptors. Most cases demonstrate improvement upon discontinuation of metronidazole, highlighting the importance of early recognition. Magnetic resonance imaging plays a critical role in diagnosing metronidazole-induced encephalopathy, with characteristic imaging findings frequently observed in the dentate nuclei and corpus callosum.

Case summary: A 63-year-old man treated with metronidazole for lumbar spondylodiscitis developed neurological symptoms consistent with metronidazole-induced encephalopathy.

Images: Magnetic resonance imaging revealed characteristic bilateral hyperintense lesions in the cerebellar dentate nuclei, corpus callosum, and brainstem. Prompt recognition and discontinuation of metronidazole led to symptom resolution.

Conclusion: This case underscores the importance of clinicians and radiologists being aware of this condition and emphasizes the pivotal role of magnetic resonance imagining in establishing the diagnosis.

一名脊柱盘炎症患者甲硝唑诱发的脑病。
导言:甲硝唑诱发脑病是甲硝唑治疗过程中一种不常见但可能很严重的并发症。虽然确切的病理生理学仍然难以捉摸,但提出的假说包括 RNA 结合、自由基的神经毒性和神经递质受体的调节。大多数病例在停用甲硝唑后病情会有所好转,这凸显了早期识别的重要性。磁共振成像在诊断甲硝唑诱发脑病中起着关键作用,其特征性成像结果经常在齿状核和胼胝体中观察到。病例摘要:一名 63 岁的男子因腰椎盘炎接受甲硝唑治疗后,出现了与甲硝唑诱发脑病一致的神经症状:磁共振成像显示小脑齿状核、胼胝体和脑干出现特征性双侧高强度病变。及时发现并停用甲硝唑后,症状得到缓解:本病例强调了临床医生和放射科医生了解这种疾病的重要性,并强调了磁共振成像在确诊中的关键作用。
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来源期刊
Clinical Toxicology
Clinical Toxicology 医学-毒理学
CiteScore
5.70
自引率
12.10%
发文量
148
审稿时长
4-8 weeks
期刊介绍: clinical Toxicology publishes peer-reviewed scientific research and clinical advances in clinical toxicology. The journal reflects the professional concerns and best scientific judgment of its sponsors, the American Academy of Clinical Toxicology, the European Association of Poisons Centres and Clinical Toxicologists, the American Association of Poison Control Centers and the Asia Pacific Association of Medical Toxicology and, as such, is the leading international journal in the specialty.
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