{"pk":1031,"title":"Metronidazole, an Uncommon Cause of Dizziness and Ataxia in the Emergency Department: A Case Report","subtitle":null,"abstract":"Introduction:\n Metronidazole, a nitroimidazole antibiotic, is a well-known antibacterial and antiprotozoal agent that is generally well tolerated without many serious side effects. Most adverse reactions affect the gastrointestinal or genitourinary system, but the central nervous system may also be afflicted. In addition to headache and dizziness, cerebellar dysfunction can occur with metronidazole use.\nCase Report:\n We discuss the clinical presentation and imaging findings of metronidazole-induced encephalopathy in a 12-year-old male. The patient had a history of Crohn’s disease and chronic Clostridium difficile infection for which he had received metronidazole for approximately 75 days prior to arrival to a local emergency department (ED). He presented with five days of progressive vertigo, nausea, vomiting, and ataxia. Subsequent magnetic resonance imaging showed symmetric hyperintense dentate nuclei lesions, characteristic of metronidazole-induced encephalopathy. The patient’s symptoms improved rapidly after cessation of metronidazole, and his symptoms had completely resolved by discharge on hospital day two.\nConclusion:\n Metronidazole-induced encephalopathy is a rare cause of vertigo and ataxia that can lead to permanent sequela if not identified and treated promptly. Thus, it is important for physicians to keep this diagnosis in mind when evaluating patients on metronidazole who present to the ED with new neurologic complaints.","language":"en","license":{"name":"Creative Commons Attribution 4.0","short_name":"CC BY 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by/4.0"},"keywords":[{"word":"Metronidazole"},{"word":"case report"},{"word":"ataxia"}],"section":"Case Reports","is_remote":true,"remote_url":"https://escholarship.org/uc/item/34t2b9w2","frozenauthors":[{"first_name":"Mary","middle_name":"E.","last_name":"Starrs","name_suffix":"","institution":"Stanford University Medical Center, Department of Emergency Medicine, Palo Alto, California","department":"None"},{"first_name":"Onur","middle_name":"M.","last_name":"Yenigun","name_suffix":"","institution":"Stanford University Medical Center, Department of Emergency Medicine, Palo Alto, California","department":"None"}],"date_submitted":"2021-05-10T19:32:47Z","date_accepted":"2021-05-10T19:32:47Z","date_published":"2021-05-10T19:33:45Z","render_galley":null,"galleys":[{"label":"","type":"","path":"https://journalpub.escholarship.org/uciem_cpcem/article/1031/galley/778/download/"}]}