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Autonomic neuropathy due to metronidazole.

SAVANNAH, GA. -- Brief metronidazole treatment has been associated with a case of reversible autonomic neuropathy in a 15-year-old girl, Lisa Hobson-Webb, M.D., reported in a poster at the annual meeting of the American Association of Electrodiagnostic Medicine.

"This has never been reported in the literature," said Dr. Hobson-Webb of Wake Forest University, Winston-Salem, N.C. "There are cases of motor or sensory neuropathies after a large dose or an extended treatment period but not any reports of autonomic involvement."

Within 2 weeks of initiating 3-day metronidazole treatment for bacterial vaginitis, a 15-year-old girl developed such a severe, burning pain in the soles of her feet that she found relief only by keeping her feet and lower legs submerged in buckets of ice water at all times.

Nerve conduction studies showed reduced sensory nerve and compound muscle action potential.

The patient was placed on gabapentin and carbamazepine for pain control, and improved over several weeks. After 3 months, her neuropathy had clinically resolved and conduction studies showed normalization of autonomic function.

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Title Annotation:Infectious Diseases
Author:Sullivan, Michele G.
Publication:Pediatric News
Article Type:Brief Article
Geographic Code:1USA
Date:Sep 1, 2005
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