ISSN Number
ISSN 2771-019X
-
-
Impact Factor
1.2*
ISSN Number
ISSN 2771-019X
Impact Factor
1.2*
1Neuroradiology Department, Local Health Unit of Matosinhos, Portugal.
2Internal Medicine Department, Local Health Unit of Matosinhos, Portugal, Portugal.
3Infectious Diseases Department, Local Health Unit of Matosinhos, Portugal, Portugal.
Neuroradiology Department, Local Health Unit of Matosinhos, Portugal.
Email: joao70610@gmail.com
Received : Aug 03, 2024,
Accepted : Sep 02, 2024
Published : Sep 09, 2024,
Archived : www.jclinmedcasereports.com
Copy right Statement: Content published in the journal follows Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0). © Oliveira JN (2024).
Journal: The Journal of Clinical and Medical Images, Case Reports (JCMICR) is a fantastic resource for keeping up with the latest clinical advancements and for publishing case reports and clinical images related to a variety of medical illnesses.
A 27-year-old male with a long-standing history of chronic otitis media developed a right temporal cerebral abscess. He underwent a mastoidectomy and was treated with intravenous antibiotics, including metronidazole. The patient’s clinical condition showed signs of improvement. Nonetheless, 75 days after the initiation of antibiotic therapy, instances of vomiting and ataxia were recorded during hospitalization, and a follow-up MRI demonstrated new T2/FLAIR hyperintensity in the dentate nuclei bilaterally and the dorsal brainstem. Considering the characteristic imaging findings, along with the patient’s prolonged course of metronidazole, a diagnosis of metronidazole-induced encephalopathy was established.
Axial FLAIR Figures (Figure 1A and 1B) and coronal T2-weighted Figure (Figure 1C) show T2/FLAIR hyperintensity in the dentate nuclei bilaterally and the dorsal brainstem.
Encephalopathy induced by metronidazole tends to occur more frequently with prolonged therapy or higher doses, often resulting in cerebellar dysfunction. MRI scans typically reveal bilateral and symmetrical abnormalities, primarily affecting the dentate nuclei of the cerebellum and the dorsal brainstem. Clinicians must recognize this potential complication and promptly discontinue metronidazole treatment. In some instances, despite cessation of the medication, a minority of patients may experience lasting neurological deficits.
