Neurological complications during treatment of liver abscess: think of metronidazole toxicity

Arora, Navneet; Wasti, Kushal P; Babbar, Navida; Saroch, Atul; Pannu, Ashok Kumar; Sharma, Navneet

doi:10.1177/0049475520903651

Cited by 5 publications

(3 citation statements)

References 7 publications

(14 reference statements)

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“…Though ordinarily safe, under rare circumstances this drug is capable of causing serious central nervous system disturbances. In particular, metronidazole neurotoxicity as well as characteristic bilateral symmetrical cerebellar dentate hyperintensities have been shown on brain magnetic resonance imaging[ 58 ]. However, neurotoxicity is not dependent on dose, and with discontinuation of the drug it can be fully reversed[ 57 , 58 ].…”

Section: Treatmentmentioning

confidence: 99%

“…In particular, metronidazole neurotoxicity as well as characteristic bilateral symmetrical cerebellar dentate hyperintensities have been shown on brain magnetic resonance imaging[ 58 ]. However, neurotoxicity is not dependent on dose, and with discontinuation of the drug it can be fully reversed[ 57 , 58 ]. Additionally, it is still unknown what effects, if any, the drug has when used by pregnant or lactating patients (and consequently in breastfeeding infants)[ 54 ].…”

Section: Treatmentmentioning

confidence: 99%

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Amebic liver abscess by Entamoeba histolytica

Usuda¹,

Tsuge²,

Sakurai³

et al. 2022

World J Clin Cases

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Amebic liver abscesses (ALAs) are the most commonly encountered extraintestinal manifestation of human invasive amebiasis, which results from Entamoeba histolytica ( E. histolytica ) spreading extraintestinally. Amebiasis can be complicated by liver abscess in 9% of cases, and ALAs led to almost 50000 fatalities worldwide in 2010. Although there have been fewer and fewer cases in the past several years, ALAs remain an important public health problem in endemic areas. E. histolytica causes both amebic colitis and liver abscess by breaching the host’s innate defenses and invading the intestinal mucosa. Trophozoites often enter the circulatory system, where they are filtered in the liver and produce abscesses, and develop into severe invasive diseases such as ALAs. The clinical presentation can appear to be colitis, including upper-right abdominal pain accompanied by a fever in ALA cases. Proper diagnosis requires nonspecific liver imaging as well as detecting anti- E. histolytica antibodies; however, these antibodies cannot be used to distinguish between a previous infection and an acute infection. Therefore, diagnostics primarily aim to use PCR or enzyme-linked immunosorbent assay to detect E. histolytica . ALAs can be treated medically, and percutaneous catheter drainage is only necessary in approximately 15% of cases. The indicated treatment is to administer an amebicidal drug (such as tinidazole or metronidazole) and paromomycin or other luminal cysticidal agent for clinical disease. Prognosis is good with almost universal recovery. Establishing which diagnostic methods are most efficacious will necessitate further analysis of similar clinical cases.

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Section: Treatmentmentioning

confidence: 99%

Section: Treatmentmentioning

confidence: 99%

Amebic liver abscess by Entamoeba histolytica

Usuda¹,

Tsuge²,

Sakurai³

et al. 2022

World J Clin Cases

View full text Add to dashboard Cite

show abstract

“…MTZ is a synthetic antibiotic derivatized from azomycin, it has been effective against Giardia lamblia and a variety of infections due to its high e cacy compared with others drugs; however, their side effects must be considered such as nausea, abdominal pain, and diarrhea (31; 32). Nevertheless, serious neurotoxicity, optic neuropathy, peripheral neuropathy, and encephalopathy have been reported in rare cases, the neurotoxicity is not dose-dependent and is fully reversible with discontinuation of the drug (33).…”

Section: Introductionmentioning

confidence: 99%

Efficacy of Anti-tubulin drug ( Paclitaxel ) as a single treatment and its combination with the commercially used drug metronidazole in the treatment of Giardiasis in the experimentally infected mice

elgendy,

Ramadan,

Farid

et al. 2024

Preprint

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Giardia infection is still a medical problem in the world as yet; it is the first cause of intestinal diarrhea and its consequences. The reliance on metronidazole as a basic treatment remains despite its side effects, especially when used for longer periods due to recurring infections, so research is ongoing to find participant for metronidazole in the treatment of giardia and at the same time works to limit its side effects. Cancer patients were shown to be 1.24 fold more susceptible and were at a higher risk of infection, which should alert physicians to the possible consequences. The study represents a step to lighten the burden on cancer patients who more exposed to Giardia infection. The importance of the participation of the Paclitaxel in the therapeutic protocol, developing anti-giardial compound that target the cell division machineries of the parasite, and reduce the genotoxicity effects of metronidazole. the dual treatment (metronidazole with Paclitaxel combination), yield a significant reduction in the percentage of IgA and IgG antibodies indicating an increase in the evanescence of the antigens that stimulate the production of antibodies. It is true that the dual treatment gave less removal of the number of eggs in the stool, as well as the trophozoite than metronidazole alone, but it gave better disappearance of the pathogens which stimulate the production of antibodies and it is also and this is the most important thing that it is safer to use, especially if it is required to prolong the treatment period, this is confirmed by histopathological examination for Liver and small intestine tissue samples collected from all mice within the different groups.

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Metronidazole

2020

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Neurological complications during treatment of liver abscess: think of metronidazole toxicity

Cited by 5 publications

References 7 publications

Amebic liver abscess by Entamoeba histolytica

Amebic liver abscess by Entamoeba histolytica

Efficacy of Anti-tubulin drug ( Paclitaxel ) as a single treatment and its combination with the commercially used drug metronidazole in the treatment of Giardiasis in the experimentally infected mice

Metronidazole

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