Ceftazidime overdose-related nonconvulsive status epilepticus after intraperitoneal instillation.
We report a case of ceftazidime-related nonconvulsive status epilepticus (NCSE) in a 70-year-old female patient with continuous ambulatory peritoneal dialysis (CAPD)-related peritonitis. She was given ceftazidime intravenously which was then changed to intraperitoneal installation after clinical improvement. She received 11 g of ceftazidime via intraperitoneal installation for two days after being discharged from the hospital. Her consciousness was altered with mutism, asterisxis, and horizontal nystagmus. Her EEG showed continuous generalized three spikes-and-wave per second that were abolished after intravenous diazepam. Ceftazidime-related NCSE was suggested and ceftazidime therapy was stopped. Hemodialysis was done while phenytoin was also given to control the convulsions. Her consciousness improved after hemodialysis. Serum ceftazidime measured before and after hemodialysis on the second and third day were 105.2/39.4, 36.2/5.2 microg/mL (normal peak level 55 microg/mL), respectively. Repeated evaluation on day 6 showed normal EEG without epileptiform activity. She was later discharged with full recovery.
Vannaprasaht
Suda
S
Department of Medicine, Srinagarind Hospital, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand. sudvan@kku.ac.th
Tawalee
Arporn
A
Mayurasakorn
Nutdhakarn
N
Yodwut
Chattanong
C
Bansong
Ratiporn
R
Reungjui
Sirirat
S
Tiamkao
Somsak
S
D000368:Aged; D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000097:blood / Q000506:poisoning*; D000927:Anticonvulsants / Q000627:therapeutic use; D002442:Ceftazidime / Q000008:administration & dosage / Q000097:blood / Q000506:poisoning*; D062787:Drug Overdose; D004569:Electroencephalography; D005260:Female; D006801:Humans; D007274:Injections, Intraperitoneal; D010672:Phenytoin / Q000627:therapeutic use; D006435:Renal Dialysis; D013226:Status Epilepticus / Q000139:chemically induced* / Q000188:drug therapy / Q000628:therapy
D000900:Anti-Bacterial Agents; D000927:Anticonvulsants; D010672:Phenytoin; D002442:Ceftazidime