Shah Siddharth, Bland Stephanie
Pediatric Nephrology, Norton Children's Hospital and University of Louisville, Louisville, USA.
Pediatrics, Norton Children's Hospital and University of Louisville, Louisville, USA.
Cureus. 2021 Mar 12;13(3):e13842. doi: 10.7759/cureus.13842.
Cefepime-induced encephalopathy with associated complications is a relatively rare but known adverse reaction that appears to occur more commonly in the elderly population with concomitant renal dysfunction or pre-existing central nervous system disease. The description of neurological features in pediatric patients secondary to cefepime-induced encephalopathy has rarely been reported, often delaying diagnosis and treatment. We report a 13-year-old female with end-stage renal disease, maintained on hemodialysis, who developed acute neurological symptoms of aphasia, myoclonus, hallucinations, seizures, and altered mental status after two days of cefepime treatment. After prompt discontinuation of cefepime and urgent hemodialysis, the neurological symptoms were resolved. Our patient had complete neurological recovery within 24 hours of the initial presentation of neurological symptoms. Recognizing the possibility of encephalopathy related to cefepime administration in high-risk pediatric patients should prompt close neurological monitoring when under treatment. Hemodialysis may help rapidly reverse the symptoms of cefepime-induced encephalopathy.
头孢吡肟诱发的脑病及相关并发症是一种相对罕见但已知的不良反应，似乎更常见于伴有肾功能不全或原有中枢神经系统疾病的老年人群。关于头孢吡肟诱发的脑病继发于儿科患者的神经学特征描述很少被报道，常常延误诊断和治疗。我们报告一名13岁患有终末期肾病且维持血液透析治疗的女性患者，在接受头孢吡肟治疗两天后出现失语、肌阵挛、幻觉、癫痫发作及精神状态改变等急性神经症状。在迅速停用头孢吡肟并紧急进行血液透析后，神经症状得到缓解。我们的患者在出现神经症状的最初24小时内神经功能完全恢复。认识到高危儿科患者中与使用头孢吡肟相关的脑病可能性，在治疗时应促使进行密切的神经学监测。血液透析可能有助于迅速逆转头孢吡肟诱发的脑病症状。
