Metronidazole-Induced Encephalopathy in a Patient With Metastatic Cancer.

Document Type

Article

Publication Date

1-2026

Abstract

Metronidazole-induced encephalopathy (MIE) is a rare adverse effect from long-term metronidazole use. We describe a patient with metastatic cancer and complicated abscesses on long-term antibiotics who presented to the emergency department with acute encephalopathic features including reported weakness and confusion. Physical examination was remarkable for chronic right-sided weakness from a previous stroke and reported abnormal right-sided finger-to-nose testing, which may have been due to weakness from his prior stroke. Head CT was non-contributory, and brain MRI showed bilateral edema in cerebellar dentate nuclei, suggestive of MIE. We recommend having a low threshold for brain MRI in patients on long-term metronidazole to rule out other diagnoses and, in patients with lasting neurologic deficits, early neurology and palliative care involvement to improve quality of life.

Publication Title

Cureus

Volume

18

Issue

1

First Page

102331

Last Page

102331

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