ABSTRACT
Prolonged neurological symptoms such as "brain fog" and cognitive impairment have occurred after coronavirus disease 2019 (COVID-19) infection. In this report, we describe impaired consciousness caused by cefepime hydrochloride (CFPM) in a patient with cognitive sequalae of COVID-19. A 56-year-old male patient was diagnosed with penile abscess after COVID-19 infection, and a blood culture detected two drug-resistant Pseudomonas aeruginosa strains. Therefore, CFPM 2 g × twice/day was administered on day 71 after intensive care unit admission. Approximately 48 h after CFPM administration, the patient showed disturbances in consciousness. Contrast-enhanced computed tomography, magnetic resonance imaging, and spinal fluid examination revealed no obvious abnormalities. Therefore, CFPM-induced neurotoxicity was suspected. CFPM was discontinued and ceftazidime 2 g × three times/day was initiated. The patient's consciousness improved 30 h after the final administration of CFPM. Serum CFPM concentrations were 14.2, 21.7, 21.7, and 11.9 µg/mL on days 1, 2, and 3 after the initiation of CFPM and on the day after CFPM was discontinued, respectively. In conclusion, intensivists should pay attention to new neurological symptoms such as CFPM-induced encephalopathy in patients with prolonged neurological symptoms after COVID-19 infection.
Subject(s)
Brain Diseases , COVID-19 Drug Treatment , COVID-19 , Anti-Bacterial Agents/adverse effects , Brain Diseases/chemically induced , Brain Diseases/diagnostic imaging , COVID-19/complications , Cefepime/adverse effects , Cephalosporins/adverse effects , Humans , Male , Middle AgedABSTRACT
Current status of the novel coronavirus : an urgent discussion / Kentaro Iwata, Naoki Kishida, Kutsuna Kenshi, Fumie Sakamoto[ speaker] ・Novel coronavirus infection : extra edition / Kutsuna Kenshi [author] ・Infectious Diseases and the Infectious Disease Consultant : Dr. Kishida's Challenge / Kishida Naoki [author]
ABSTRACT
Current status of the novel coronavirus : an urgent discussion / Kentaro Iwata, Naoki Kishida, Kutsuna Kenshi, Fumie Sakamoto[ speaker] ・Novel coronavirus infection : extra edition / Kutsuna Kenshi [author] ・Infectious Diseases and the Infectious Disease Consultant : Dr. Kishida's Challenge / Kishida Naoki [author]