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March 1983, Vol 137, No. 3 >
Article | March 1983

Encephalopathy With Metronidazole in a Child FREE

JULIAN BAILES, MD; JOHN WILLIS, MD; CEDRIC PRIEBE, MD; RICHARD STRUB, MD
Am J Dis Child. 1983;137(3):290-291. doi:10.1001/archpedi.1983.02140290076021.
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Recent reports imply that high doses of metronidazole hydrochloride cause CNS toxic effects in adults.1,2 To our knowledge, such toxic effects have not been reported in children. We describe a child who experienced seizures and prolonged neurologic abnormalities after the administration of intravenous (IV) metronidazole.

Report of a Case.—A previously well 12-year-old boy had surgery for a perforated appendix and generalized peritonitis on June 9, 1981. Postoperatively, therapy with IV tobramycin sulfate, 50 mg every eight hours, and clindamycin phosphate, 175 mg every six hours, was started; chloramphenicol sodium succinate, 600 mg every six hours, was added on June 11 because of persistent fever and abdominal tenderness. Tobramycin and chloramphenicol therapy was stopped on June 14, when the initial peritoneal culture showed Escherichia coli resistant to those drugs. Intravenous gentamicin sulfate, 70 mg every eight hours, and cefamandole nafate, 1 g every eight hours, were then added to the

REFERENCES

1 +
Frytak S, Moertel CG, Childs DS, et al:  Neurologic toxicity associated with high-dose metronidazole therapy . Ann Intern Med 1978;;88: 361-362.
2 +
Kusumi RK, Plouffe JF, Wyatt RH, et al:  Central nervous system toxicity associated with metronidazole therapy . Ann Intern Med 1980;;93: 59-60.
3 +
Bradley WG, Karlsson IJ, Rassol CG:  Metronidazole neuropathy . Br Med J 1977;;2:610-611.
4 +
Coxon A, Pallis CA:  Metronidazole neuropathy . J Neurol Neurosurg Psychiatry 1976;;39:403-405.
5 +
Itil TM, Holden JMC, Keskiner A, et al:  Central effects of metronidazole , in Cole J (ed): Psychiatric Research Reports of the American Psychiatric Association . Washington, DC, American Psychiatric Association, 1968;, vol 24, chap 10.
6 +
Placidi GF, Masuoka D, Alcaraz A, et al:  Distribution and metabolism of 14C-metronidazole in mice . Arch Int Pharmacodyn Ther 1970;;188:168-179.
7 +
Von Rogulja P, Kovac W, Schmid H:  Metronidazol-Encephalopathie des Ratte . Acta Neuropathol 1973;;25:36-45.
8 +
Scharer K:  Selective injury to Purkinje cells in the dog after administration of high-dose nitroimidazole derivatives . Verh Dtsch Ges Pathol 1972;;56:407-410.

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Country-Specific Mortality and Growth Failure in Infancy and Yound Children and Association With Material Stature

Use interactive graphics and maps to view and sort country-specific infant and early dhildhood mortality and growth failure data and their association with maternal

References

1 +
Frytak S, Moertel CG, Childs DS, et al:  Neurologic toxicity associated with high-dose metronidazole therapy . Ann Intern Med 1978;;88: 361-362.
2 +
Kusumi RK, Plouffe JF, Wyatt RH, et al:  Central nervous system toxicity associated with metronidazole therapy . Ann Intern Med 1980;;93: 59-60.
3 +
Bradley WG, Karlsson IJ, Rassol CG:  Metronidazole neuropathy . Br Med J 1977;;2:610-611.
4 +
Coxon A, Pallis CA:  Metronidazole neuropathy . J Neurol Neurosurg Psychiatry 1976;;39:403-405.
5 +
Itil TM, Holden JMC, Keskiner A, et al:  Central effects of metronidazole , in Cole J (ed): Psychiatric Research Reports of the American Psychiatric Association . Washington, DC, American Psychiatric Association, 1968;, vol 24, chap 10.
6 +
Placidi GF, Masuoka D, Alcaraz A, et al:  Distribution and metabolism of 14C-metronidazole in mice . Arch Int Pharmacodyn Ther 1970;;188:168-179.
7 +
Von Rogulja P, Kovac W, Schmid H:  Metronidazol-Encephalopathie des Ratte . Acta Neuropathol 1973;;25:36-45.
8 +
Scharer K:  Selective injury to Purkinje cells in the dog after administration of high-dose nitroimidazole derivatives . Verh Dtsch Ges Pathol 1972;;56:407-410.

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