Investigative Magnetic Resonance Imaging

Korean Society of Magnetic Resonance in Medicine (대한자기공명의과학회)
권호 표지
DOI QR코드

DOI QR Code

A Case of Metronidazole-Induced Encephalopathy: Atypical Involvement of the Brain on MRI

  • Hwang, Eunjin (Department of Radiology, Hallym University Dongtan Sacred Heart Hospital) ;
  • Chang, Suk-Ki (Department of Radiology, Hallym University Dongtan Sacred Heart Hospital) ;
  • Lee, Seun-Ah (Department of Radiology, Hallym University Dongtan Sacred Heart Hospital) ;
  • Choi, Jung-Ah (Department of Radiology, Hallym University Dongtan Sacred Heart Hospital)
  • Received : 2018.05.07
  • Accepted : 2018.06.23
  • Published : 2018.09.30
Download PDF
⟨ Previous Next ⟩

Abstract

Metronidazole is an antimicrobial agent widely used for the treatment of anaerobic infection or antibiotics-associated diarrhea. It is generally thought to be safe, but can induce reversible toxic encephalopathy in the case of excessive or cumulative over-dose. Metronidazole-induced encephalopathy generally demonstrates the characteristic features of typical lesion location and bilaterality on magnetic resonance imaging (MRI). We report a case of metronidazole-induced encephalopathy with the involvement of asymmetric white matter. To our knowledge, only a few cases have been reported with respect to white matter lesion characteristics on MRI with diffusion-weighted images.

Keywords

References

  1. Bahn Y, Kim E, Park C, Park HC. Metronidazole induced encephalopathy in a patient with brain abscess. J Korean Neurosurg Soc 2010;48:301-304 https://doi.org/10.3340/jkns.2010.48.3.301
  2. Kim E, Na DG, Kim EY, Kim JH, Son KR, Chang KH. MR imaging of metronidazole-induced encephalopathy: lesion distribution and diffusion-weighted imaging findings. AJNR Am J Neuroradiol 2007;28:1652-1658 https://doi.org/10.3174/ajnr.A0655
  3. Park HS, Han DS. Management of antibiotics-associated diarrhea. Korean J Gastroenterol 2009;54:5-12 https://doi.org/10.4166/kjg.2009.54.1.5
  4. Graves TD, Condon M, Loucaidou M, Perry RJ. Reversible metronidazole-induced cerebellar toxicity in a multiple transplant recipient. J Neurol Sci 2009;285:238-240 https://doi.org/10.1016/j.jns.2009.06.011
  5. Dow SW, LeCouteur RA, Poss ML, Beadleston D. Central nervous system toxicosis associated with metronidazole treatment of dogs: five cases (1984-1987). J Am Vet Med Assoc 1989;195:365-368
  6. Olson EJ, Morales SC, McVey AS, Hayden DW. Putative metronidazole neurotoxicosis in a cat. Vet Pathol 2005;42:665-669 https://doi.org/10.1354/vp.42-5-665
  7. Scharer K. Selective alterations of Purkinje cells in the dog after oral administration of high doses of nitroimidazole derivatives (author's transl). Verh Dtsch Ges Pathol 1972;56:407-410
  8. von Rogulja P, Kovac W, Schmid H. Metronidazol encephalopathy in rats. Acta Neuropathol 1973;25:36-45 https://doi.org/10.1007/BF00686856
  9. Ahmed A, Loes DJ, Bressler EL. Reversible magnetic resonance imaging findings in metronidazole-induced encephalopathy. Neurology 1995;45:588-589 https://doi.org/10.1212/WNL.45.3.588

Cited by

  1. Antibiotic-induced epileptic seizures: mechanisms of action and clinical considerations vol.81, pp.None, 2018, https://doi.org/10.1016/j.seizure.2020.08.012