Ertapenem-induced encephalopathy
| Autor: | Rebecca Adams, Aaron Calderon, Priya Chopra, Richard Miranda |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
Ertapenem
Male Side effect Hallucinations Encephalopathy 030232 urology & nephrology law.invention 03 medical and health sciences chemistry.chemical_compound 0302 clinical medicine law polycyclic compounds Medicine Humans 030212 general & internal medicine Empyema Unexpected Outcome (Positive or Negative) Including Adverse Drug Reactions business.industry Acute kidney injury Delirium General Medicine Middle Aged medicine.disease Intensive care unit Discontinuation Anti-Bacterial Agents body regions Treatment Outcome chemistry Withholding Treatment Anesthesia Neurotoxicity Syndromes medicine.symptom business Akathisia Drug-Induced |
| Zdroj: | BMJ Case Rep |
| ISSN: | 1757-790X |
| Popis: | Neurotoxicity is an unusual side effect of carbapenems, and it has been reported most commonly presenting as seizures, encephalopathy and hallucinations. Ertapenem neurotoxicity most classically presents as seizures in patients with end-stage renal disease (estimated glomerular filtration rate (eGFR) 2). We present a patient with a baseline eGFR of 30–59 mL/min/1.73 m2 with acute kidney injury who developed non-seizure neurotoxicity after ertapenem exposure. This patient is a middle-aged Caucasian man who received intravenous ertapenem for treatment of empyema. Although the empyema improved, he developed delirium beginning on day 7 of ertapenem. The delirium progressed to constant agitation and visual hallucinations requiring transfer to the intensive care unit with eventual intubation for airway protection. No improvement in mental status was observed with cessation of other medications. Ertapenem was discontinued and within 24 hours, he was extubated, and his mental status returned to baseline. He was discharged from the hospital the following day. The timely resolution after ertapenem discontinuation makes ertapenem-induced encephalopathy the most likely explanation for this patient’s course. |
| Databáze: | OpenAIRE |
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