Nonconvulsive status epilepticus due to cefepime in a patient with normal renal function.
Status epilepticus and encephalopathy have been reported with use of cephalosporins in patients with renal failure. We here report the case of a 79-year-old patient with normal renal function who developed subtle mental status changes during cefepime therapy for urinary tract infection. Emergent electroencephalography revealed evidence of nonconvulsive status epilepticus (NCSE), which responded initially to lorazepam. Later, the patient's NCSE gradually resolved only after cefepime was discontinued, with mental status returning to baseline as the electroencephalography changes resolved. It should be recognized that cefepime therapy can cause NCSE even in the presence of normal renal function. Measurement of serum concentrations and changes in dosing guidelines can probably prevent NCSE during cefepime therapy.
Maganti
Rama
R
Marshfield Clinic--Wausau Center, Wausau, WI, USA. maganti.rama@marshfieldclinic.org
Jolin
David
D
Rishi
Daljeet
D
Biswas
Amit
A
D000368:Aged; D000900:Anti-Bacterial Agents / Q000009:adverse effects* / Q000627:therapeutic use; D000927:Anticonvulsants / Q000627:therapeutic use*; D000077723:Cefepime; D002511:Cephalosporins / Q000009:adverse effects* / Q000627:therapeutic use; D004569:Electroencephalography; D005260:Female; D006801:Humans; D008140:Lorazepam / Q000627:therapeutic use*; D013226:Status Epilepticus / Q000139:chemically induced* / Q000188:drug therapy; D014552:Urinary Tract Infections / Q000188:drug therapy
D000900:Anti-Bacterial Agents; D000927:Anticonvulsants; D002511:Cephalosporins; D000077723:Cefepime; D008140:Lorazepam