{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T09:12:57Z","timestamp":1790241177038,"version":"4.1.0"},"reference-count":11,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2025,10,20]],"date-time":"2025-10-20T00:00:00Z","timestamp":1760918400000},"content-version":"vor","delay-in-days":19,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2025,10,1]],"date-time":"2025-10-01T00:00:00Z","timestamp":1759276800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Case Reports"],"published-print":{"date-parts":[[2025,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>Metronidazole is a commonly used antibiotic effective against anaerobic bacterial and protozoal infections. While generally well tolerated, it is associated with potential neurotoxic effects, including metronidazole\u2010induced encephalopathy (MIE), especially in elderly patients or those with hepatic impairment. We report the case of a 79\u2010year\u2010old woman with a significant medical history who developed neurological symptoms following metronidazole treatment. Initially treated with broad\u2010spectrum antibiotics, she showed limited response, prompting the addition of metronidazole to address suspected amebic infections alongside ongoing therapy with meropenem. Although effective in reducing the abscess size from 12 to 5\u2009cm, the patient subsequently experienced altered mental status and cognitive decline. MRI findings were consistent with MIE. Upon discontinuation of metronidazole, the patient demonstrated notable recovery in cognitive function, confirming the diagnosis and emphasizing the importance of recognizing MIE in at\u2010risk populations. This case underscores the need for careful monitoring and early recognition of neurological complications associated with metronidazole therapy, particularly in older patients or those with comorbidities. Increased awareness among healthcare providers is essential to optimize patient outcomes and prevent unnecessary suffering.<\/jats:p>","DOI":"10.1002\/ccr3.71332","type":"journal-article","created":{"date-parts":[[2025,10,21]],"date-time":"2025-10-21T04:02:03Z","timestamp":1761019323000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["From Treatment to Toxicity: Metronidazole\u2010Induced Encephalopathy in a 79\u2010Year\u2010Old Woman"],"prefix":"10.1002","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8058-6467","authenticated-orcid":false,"given":"Minoo","family":"Heidari Almasi","sequence":"first","affiliation":[{"name":"Imam Hossein Hospital Clinical Research Development Unit Shahid Beheshti University of Medical Sciences  Tehran Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2235-3742","authenticated-orcid":false,"given":"Seyyed Amirhossein","family":"Salehi","sequence":"additional","affiliation":[{"name":"Student Research Committee, School of Medicine Shahid Beheshti University of Medical Sciences  Tehran Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Afsaneh","family":"Safarian","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine Loghman Hakim Hospital, Shahid Beheshti University of Medical Science  Tehran Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Parisa","family":"Delkash","sequence":"additional","affiliation":[{"name":"Department of Adult Rheumatology, School of Medicine, Imam Hossein Hospital Shahid Beheshti University of Medical Sciences  Tehran Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5056-4574","authenticated-orcid":false,"given":"Hamideh","family":"Moradi Shahrebabak","sequence":"additional","affiliation":[{"name":"Imam Hossein Hospital Clinical Research Development Unit Shahid Beheshti University of Medical Sciences  Tehran Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,10,20]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1093\/jac\/dkx351"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11908-014-0396-y"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejmech.2015.06.019"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/B978-1-4377-0310-8.00018-X"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/codi.15385"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.4102\/sajr.v25i1.2016"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00415-018-9147-6"},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.1503\/cmaj.201671"},{"key":"e_1_2_12_10_1","doi-asserted-by":"publisher","DOI":"10.4254\/wjh.v16.i3.316"},{"key":"e_1_2_12_11_1","doi-asserted-by":"publisher","DOI":"10.1503\/cmaj.090591"},{"issue":"12","key":"e_1_2_12_12_1","article-title":"Metronidazole\u2010Induced Encephalopathy (MIE)","volume":"14","author":"Chaudhari D. M.","year":"2022","journal-title":"Cureus"}],"container-title":["Clinical Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ccr3.71332","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/ccr3.71332","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ccr3.71332","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T08:55:26Z","timestamp":1790240126000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/ccr3.71332"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,10]]},"references-count":11,"journal-issue":{"issue":"10","published-print":{"date-parts":[[2025,10]]}},"alternative-id":["10.1002\/ccr3.71332"],"URL":"https:\/\/doi.org\/10.1002\/ccr3.71332","archive":["Portico"],"relation":{},"ISSN":["2050-0904","2050-0904"],"issn-type":[{"value":"2050-0904","type":"print"},{"value":"2050-0904","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,10]]},"assertion":[{"value":"2025-04-07","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-09-17","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-10-20","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e71332"}}