Cefepime
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Encephalopathy: case report An 82-year-old woman developed encephalopathy during treatment with cefepime for urinary tract infection. The woman, who had stage V chronic kidney disease presented with new onset of altered mental status, slurred speech and upper extremity tremors. Four days prior to the current presentation, she was diagnosed with multidrug resistant Pseudomonas aeruginosa related urinary tract infection for which she was started on cefepime [route and dosage not stated]. However, she experienced tremors of upper extremities, aphasia and worsening of general condition. Subsequently, she was hospitalised. Physical examination showed poverty of speech, drowsiness and prominent bilateral resting hand tremor. Her Blood urea nitrogen and serum creatinine levels were normal and a brain MRI did not show any abnormalities. The woman was empirically started on phenytoin. An EEG was performed to determine evidence of seizures. The EEG showed stimulus-induced rhythmic periodic or ictal discharges (SIRPIDS) suggestive of cefepime induced encephalopathy. Thereafter, her cefepime and phenytoin were stopped. Over subsequent 48h, her mental status normalised and a repeat EEG showed resolution of SIRPIDS. Author comment: "Cefepime induced encephalopathy, with SIRPIDS on EEG, is a rare but reported cause of altered sensorium with seizure activity". Ladd J, et al. Seizure or sirpids? a case of altered mental status. Journal of Hospital Medicine 13 (Suppl. 1): no pagination abstr. 673, No. 4, 2018. Available from: URL: https://www.shmabstracts.com/abstract/seizure-or-sirpids-a-case-of-altered803432417 mental-status/ [abstract] - USA
0114-9954/19/1778-0001/$14.95 Adis © 2019 Springer Nature Switzerland AG. All rights reserved
Reactions 9 Nov 2019 No. 1778
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