Metronidazole
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Cerebellar toxicities and dry mucosa: case report A 70-year-old man developed dry mucosa and cerebellar toxicity in the from of dysarthria, dysmetria, disorientated, feeling of instability during treatment with metronidazole for sacral osteomyelitis [routes, dosages and duration of treatment to reactions onset not stated]. The man, who had a complex medical history, was admitted in March 2020 due to various symptoms and was diagnosed with sacral osteomyelitis. He was therefore started on metronidazole and ciprofloxacin for 6 weeks. Subsequently, he became disoriented, developed dysarthria with a feeling of instability for 4 days. His family requested home assessment from primary care. On the examination performed by the primary care physician at home, he was noted to have mucocutaneous paleness, dry mucosa, BP of 100/70mm Hg, oxygen saturation of 98% and temperature of 36.5°C. On neurologic examination, dysarthria and dysmetria in the finger-to-nose manoeuvre were observed. He was shifted to the hospital emergency department (ED). During his stay in the ED, he underwent various investigations. CT scan findings indicated underlying chronic degenerative ischaemic aetiology. Based on investigations and clinical presentation, he was admitted to the internal medicine department, where he underwent a cranial MRI. He was considered to have cerebellar toxicity, which was suspected to be related to metronidazole. The man’s therapy with metronidazole was stopped with favourable outcome. He showed progressive improvement of the dysarthria, as well as complete disappearance of instability feeling. Ten days after the admission, a repeat cranial MRI showed normal findings. Gutierrez-Soto B, et al. Cerebellar toxicity after prolonged use of metronidazole. [Spanish]. Semergen Sociedad Espanola de Medicina Rural y Generalista : 12 Aug 2020. Available from: URL: http://doi.org/10.1016/j.semerg.2020.06.021 [Spanish; summarised from a translation] 803504999
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Reactions 3 Oct 2020 No. 1824
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