title: Colistin-mediated neurotoxicity.
abstract: We describe a 51-year-old man who developed renal and neural toxicity after the administration of colistin. He developed respiratory apnoea, neuromuscular blockade and severe comatose encephalopathy with the lack of brainstem reflexes. After discontinuation of the antibiotic, he made a prompt recovery to his baseline neurological function. The case illustrates the importance of recognising the toxicities associated with colistin. Although recent literature details its nephrotoxicity, current data have been discordant with the rare cases of respiratory apnoea or neuromuscular blockade once cited over 30 years ago. Additionally, no cases have ever described the profound encephalopathy with lack of brainstem function described here. The awareness of colistin's potentially fatal effects must be kept in mind when administering this antibiotic. Vigilance of the encephalopathic picture can also facilitate the diagnosis of colistin-mediated neurotoxicity in a patient with altered mental status of otherwise unknown aetiology.
authors.affiliation: Rush University Medical Center, Chicago, Illinois, USA.
authors.forename: Subeer
authors.initials: S
authors.lastname: Wadia
authors.affiliation: Department of Pulmonary and Critical Care, Rush University Medical Center, Chicago, Illinois, USA.
authors.forename: Betty
authors.initials: B
authors.lastname: Tran
mesh_terms: D000900:Anti-Bacterial Agents / Q000009:adverse effects*; D001049:Apnea / Q000139:chemically induced*; D001933:Brain Stem / Q000187:drug effects*; D003091:Colistin / Q000009:adverse effects*; D003128:Coma / Q000139:chemically induced*; D006801:Humans; D007674:Kidney Diseases / Q000139:chemically induced; D008297:Male; D008875:Middle Aged; D009468:Neuromuscular Diseases / Q000139:chemically induced*; D020258:Neurotoxicity Syndromes / Q000209:etiology*
chemical_list: D000900:Anti-Bacterial Agents; D003091:Colistin