Metronidazole
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Encephalopathy: case report A 41-year-old man developed metronidazole-induced encephalopathy during treatment with metronidazole for decubitus ulcers. He had powdered metronidazole tablets with a gel and applied on decubitus ulcers. The man, who had a 12-year history of quadriparesis, developed decubitus ulcers and presented to hospital in India with facial deviation, slurring of speech and one seizure episode. He also had a history of type 2 diabetes. Physical examination revealed that he was oriented and conscious with slurring of speech and no meningeal signs. His blood pressure was 120/80mm Hg with a pulse rate of 101 beats per minute. Axial T2–fluid-attenuated inversion recovery (FLAIR) MRI showed a hyperintense lesion in the splenium of the corpus callosum and symmetric hyperintense lesions in the bilateral cerebellar dentate nuclei. Diffusion-weighted imaging showed a true restriction in the affected regions. Further questioning revealed that he had been using powdered metronidazole tablets with a gel over his decubitus ulcers for the previous 8 to 10 months [dosage not stated]. Metronidazole-induced encephalopathy was suspected. Metronidazole was discontinued, and the man’s symptoms improved gradually. Five days later, he was discharged in a stable condition. His symptoms resolved entirely, and no recurrence was noted after a 1-month follow-up. Mathew RP, et al. A Case of Topical Metronidazole-Induced Encephalopathy. JAMA Neurology : no pagination, 10 Aug 2020. Available from: URL: http://doi.org/10.1001/ 803501792 jamaneurol.2020.2596
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Reactions 19 Sep 2020 No. 1822
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