title: Acquired encephalopathy associated with carnitine deficiency after cefditoren pivoxil administration.
abstract: We describe a 47-year-old woman who presented with palinopsia and subacute altered mental change after cefditoren pivoxil administration. The patient showed characteristic clinical manifestations of hypocarnitinemia, which affected her state of consciousness and she had radiologic findings that revealed metabolic encephalopathy with cytotoxic edema in the right occipital area and intracranial hemorrhages in right occipital and left frontal areas. Follow-up imaging after oral carnitine supplementation demonstrated complete resolution of the bilateral frontal subcortical T2 high-intensity lesions. Carnitine deficiency due to cefditoren pivoxil treatment may present as metabolic encephalopathy in adults. This possibility should be considered with the differential diagnosis of encephalopathies, and carnitine levels should be checked in patients treated with cefditoren pivoxil.
authors.affiliation: Department of Neurology, College of Medicine, MyongjiHospital, Kwandong University, Gyeonggi-do, South Korea.
authors.forename: Heyun
authors.initials: H
authors.lastname: Kim
authors.forename: Kon
authors.initials: K
authors.lastname: Chu
authors.forename: Keun-Hwa
authors.initials: KH
authors.lastname: Jung
authors.forename: Soon-Tae
authors.initials: ST
authors.lastname: Lee
authors.forename: Jeong-Min
authors.initials: JM
authors.lastname: Kim
authors.forename: Sang Kun
authors.initials: SK
authors.lastname: Lee
mesh_terms: D000900:Anti-Bacterial Agents / Q000009:adverse effects; D001928:Brain Diseases, Metabolic / Q000139:chemically induced* / Q000175:diagnosis*; D009202:Cardiomyopathies / Q000139:chemically induced* / Q000175:diagnosis*; D002331:Carnitine / Q000172:deficiency; D002511:Cephalosporins / Q000009:adverse effects*; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D022124:Hyperammonemia / Q000139:chemically induced* / Q000175:diagnosis*; D008875:Middle Aged; D009135:Muscular Diseases / Q000139:chemically induced* / Q000175:diagnosis*
chemical_list: D000900:Anti-Bacterial Agents; D002511:Cephalosporins; C057710:cefditoren pivoxil; D002331:Carnitine