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February 13, 2017

Question of the Day – Monday February 13, 2017

Question: Metronidazole is a commonly prescribed antibiotic that has been reported to rarely induce what has been termed “metronidazole-induced encephalopathy”. What are the clinical symptoms associated with this syndrome and what are the reported brain MRI findings associated with this entity?

Answer: The cited reference notes: “Three types of symptoms have been reported: seizures, cerebellar dysfunction, and acute changes in mental status. These symptoms may develop alone or in combination. B rain MRI on T2 weighted FLAIR images reveals abnormalities, mostly within the cerebellar dentate nuclei and corpus callosum. The third cerebral ventricle [has been reported to be] sandwiched by bilateral cerebellar dentate nuclei taking the form of a “chestnut”. The abnormality within the cerebellar dentate nuclei has thus been termed the “chestnut sign” in Japan where several case with metronidazole induced encephalopathy have been reported.” (Kuriyama A. Chestnut sign: metronidazole-induced encephalopathy. 2017 J Emerge Med 52(1): 101-102)

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  • Education & Groups
    • American Board of Applied Toxicology (ABAT)
      • 2025 ABAT Election Ballot
      • ABAT Travel Grant
      • ABAT Exceptional Service Award
      • ABAT Newsletter
      • Sitting for the American Board of Applied Toxicology Exam
        • ABAT Examination Study Guide
      • Certification Renewal Documents
      • Life Long Learning Articles (LLSA)
      • ABAT Member Directory
        • Diplomate Verification
      • ABAT Board of Directors Contact Information
    • AACT Antidote Collective
    • E-Learning
      • Research Seminar: The Nuts and Bolts of Toxicology Research
      • Advanced Hazmat Life Support Training
      • TOXISMO Society for the Discussion of Scientific Literature
      • ToxNow
      • Webinars
        • ABAT Journal Club Webinars
        • COVID Webinar Series
    • Toxicology Residency & Fellowship Training Programs
    • Clinical Toxicology Guidelines Collaborative
      • Recommendations
    • ToxCoach Mentorship Program
    • Committees
      • AACT Committee Leadership Opportunities
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