Sutton S Scott, Jumper Mark, Cook Sean, Edun Babatunde, Wyatt Michael D
University of South Carolina, Columbia, SC, USA.
Dorn Veterans Affairs Medical Center, Columbia, SC, USA.
J Investig Med High Impact Case Rep. 2017 Jan 1;5(1):2324709616689376. doi: 10.1177/2324709616689376. eCollection 2017 Jan-Mar.
Drug-induced neurotoxicity is a rare adverse reaction associated with ertapenem. Encephalopathy is a type of neurotoxicity that is defined as a diffuse disease of the brain that alters brain function or structure. We report a patient with renal function who developed ertapenem-induced encephalopathy manifesting as altered mental status, hallucinations, and dystonic symptoms. The patient's symptoms improved dramatically following ertapenem discontinuation, consistent with case reports describing ertapenem neurotoxicity in renal dysfunction. Since clinical evidence strongly suggested ertapenem causality, we utilized the Naranjo Scale to estimate the probability of an adverse drug reaction to ertapenem. Our patient received a Naranjo Scale score of 7, suggesting a probable adverse drug reaction, with a reasonable temporal sequence to support our conclusion.
药物性神经毒性是与厄他培南相关的一种罕见不良反应。脑病是神经毒性的一种类型,被定义为改变脑功能或结构的弥漫性脑部疾病。我们报告了一名肾功能不全患者,其出现了厄他培南诱发的脑病,表现为精神状态改变、幻觉和张力障碍症状。在停用厄他培南后,患者症状显著改善,这与描述肾功能不全患者中厄他培南神经毒性的病例报告一致。由于临床证据强烈提示厄他培南为病因,我们使用了纳兰霍量表来评估对厄他培南发生药物不良反应的可能性。我们的患者纳兰霍量表评分为7分,提示可能发生了药物不良反应,且有合理的时间顺序来支持我们的结论。