Metronidazole is a nitroimidazole, anti-protozoal and anti-anaerobic antibiotic and is a very commonly used drug for the treatment of infections like amoebiasis, giardiasis, and trichomonas infection. The common adverse effects include nausea, vomiting, metallic taste, however rarely do patients on high and prolonged doses of metronidazole develop neurological complications like peripheral neuropathy, cerebellar ataxia, encephalopathy. We present a case of a patient who presented with abdominal symptoms and was diagnosed to have an amoebic liver abscess for which he was started on metronidazole. The patient developed encephalopathy and ataxia. MRI brain showed bilateral T2 hyperintensities in the dentate nucleus of the cerebellum, a characteristic feature of metronidazole induced injury. On stopping metronidazole patient symptoms improved and completely resolved in two weeks at follow up. It is essential to consider metronidazole as a cause for patients on long term, high dose therapy presenting with neurological symptoms.
Key words: Encephalopathy, Metronidazole, ataxia
|
