Metronidazole-Induced Toxic Encephalopathy in A Hemodialysis Patient: A Case Report / 대한신장학회지

ABSTRACT

Metronidazole, one of the mainstay drugs for the treatment of anaerobic infections and protozoal infections, may produce some serious neurological side effects. Seizure, peripheral neuropathy, dizziness, vertigo, ataxia, confusion, irritability, headache and tremor have been reported among patients receiving metronidazole, particularly among those receiving high dose of the drug. However, no specific dose adjustment is recommended for patients with renal or hepatic dysfunction receiving metronidazole because the accumulation of the drug and its metabolites can occur in terms of severity of illness and patient tolerability. Although metronidazole is significantly removed by hemodialysis, no specific dose recommendations are made for this patient population. Recently, we experienced metronidazole-induced encephalopathy in a patient with end-stage renal disease, which was diagnosed by brain magnetic resonance imaging (MRI). Herein, we report a case with a review of literature.