Central Nervous System Toxicity Associated with Metronidazole Therapy
Authors: RODNEY K. KUSUMI
Journal: Annals of Internal Medicine (1980)

Brief Reports1 July 1980Central Nervous System Toxicity Associated with Metronidazole TherapyRODNEY K. KUSUMI, M.D., JOSEPH F. PLOUFFE, M.D., ROBERT H. WYATT, M.D., ROBERT J. FASS, M.D.RODNEY K. KUSUMI, M.D., JOSEPH F. PLOUFFE, M.D., ROBERT H. WYATT, M.D., ROBERT J. FASS, M.D.Author, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-93-1-59 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptMetronidazole is a nitroimidazole compound best known as an antimicrobial agent for treating infections caused by susceptible protozoa and anaerobic bacteria. Neurologic side effects attributed to metronidazole include convulsions (1) and sensory polyneuropathy (2-4). We describe here the occurrence of encephalopathy, cerebellar dysfunction with ataxia, and sensory neuropathy associated with high-dose metronidazole therapy.A 45-year-old woman underwent a right radical mastectomy in 1965 for breast carcinoma. She subsequently received radiation therapy and chemotherapy with cyclophosphamide and 5-fluorouracil. She did well until June 1978 when she developed a draining chest-wall lesion secondary to radiation necrosis. A pedicle flap was constructed to...References1. FRYTAKMOERTELCHILDSALBERS SCDJ. Neurologic toxicity associated with high-dose metronidazole therapy. Ann Intern Med. 1978;88:361-2. LinkGoogle Scholar2. RAMSAY I. Endocrine ophthalmopathy. Br Med J 1968;4:706. CrossrefMedlineGoogle Scholar3. COXONPALLIS AC. Metronidazole neuropathy. J Neurol Neurosurg Psychiatry. 1976;39:403-5. CrossrefMedlineGoogle Scholar4. BRADLEYKARLSSONRASSOL WIC. Metronidazole neuropathy. Br Med J 1977;2:610-1. CrossrefMedlineGoogle Scholar5. BUSCHSUTTERFINEGOLD DVS. Activity of combinations of antimicrobial agents against Bacteroides fragilis. J Infect Dis. 1976;133:321-8. CrossrefMedlineGoogle Scholar6. SCHIPPERBEALEBUSHFRYER HFRC. Metronidazole as a radiosensitizer. N Engl J Med. 1976;295:901. Letter. CrossrefMedlineGoogle Scholar7. WARNERPERKINSCORDLRO JRL. Metronidazole therapy of anaerobic bacteremia, meningitis, and brain abscess. Arch Intern Med. 1979;139:167-9. CrossrefMedlineGoogle Scholar8. SCHARER K. Selective injury to purkinje cells in the dog after oral administration of high doses of nitroimidazole derivatives. Verb Dtsch Ges Pathol. 1976;36:930-6. Google Scholar9. PLACIDIMASUOKAALCARAZTAYLOREARLE GDAJR. Distribution and metabolism of 14C-metronidazole in mice. Arch Int Pharmacodyn Ther. 1970;188:168-79. MedlineGoogle Scholar10. ROGULJAKOVACSCHMID PWH. Metronidazole encephalopathy in rats. Acta Neuropathol (Berl) 1973;25:35-45. CrossrefGoogle Scholar This content is PDF only. 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