Ruiz de Villa Ariel, Charles Kipson, Bassi Raghav, Spencer Sanjae, Bazikian Yvette
Internal Medicine, University of Central Florida College of Medicine, Graduate Medical Education/Hospital Corporation of America (HCA) Healthcare North Florida Regional Medical Center, Gainesville, USA.
Cureus. 2022 Jun 16;14(6):e26005. doi: 10.7759/cureus.26005. eCollection 2022 Jun.
Cefepime-induced neurotoxicity is well-known, but an under-recognized event that can present with a myriad of neurological findings ranging from myoclonus to seizures to comatose state. It is more prevalent in patients with impaired renal clearance as it is mainly cleared by the kidneys. We present a case of a 52-year-old female who was managed in the intensive care unit with severe encephalopathy following empiric antibiotic therapy with cefepime. Although we encountered some unforeseen difficulties executing our initial plan of renal replacement therapy, our patient was successfully treated with fluids and intravenous diuresis with furosemide and was ultimately discharged home with full recovery.
头孢吡肟诱导的神经毒性是众所周知的，但却是一个未得到充分认识的事件，可表现为从肌阵挛到癫痫再到昏迷状态等无数神经系统表现。在肾清除功能受损的患者中更为常见，因为它主要通过肾脏清除。我们报告一例52岁女性患者，在接受经验性头孢吡肟抗生素治疗后，因严重脑病在重症监护病房接受治疗。尽管我们在执行最初的肾脏替代治疗计划时遇到了一些意想不到的困难，但我们的患者通过补液和静脉注射呋塞米利尿成功得到治疗，最终完全康复出院回家。
