Abstract
Non-convulsive status epilepticus related to cefepime has not been reported in childhood dialysis patients, although several adult cases have been reported. We report a state of acute confusion in a 15-year-old boy on continuous ambulatory peritoneal dialysis (CAPD) receiving cefepime that was diagnosed as status epilepticus by electroencephalography (EEG). The EEG improved after anticonvulsive therapy. All clinical symptoms disappeared dramatically within 24 h of discontinuation of cefepime. The differential diagnosis of confusional states and the mechanisms of the convulsive effects of antimicrobials in chronic renal failure are discussed. The importance that the clinician is aware of the rare side effects of antimicrobials is emphasized.
References
Wallace KL (1997) Antibiotic induced convulsions. Crit Care Clin 4:741–762
Saurina A, Vera M, Pou M, Lopez Pedret J, Darnell A, Campistol JM, Cases A (2000) Non-convulsive status epilepticus secondary to adjusted cefepime doses in patients with chronic renal failure. Nefrologia 20:554–558
Tanimu DZ, Obeid T, Awada A, Huraib S, Iqbal A (1998) Absence status: an overlooked cause of acute confusion in hemodialysis patients. J Nephrol 11:146–147
Chow KM, Wang AY, Hui ACF, Wong TY, Szeto CC, Li PK (2001) Nonconvulsive status epilepticus in peritoneal dialysis. Am J Kidney Dis 38:400–405
Dixit S, Kurle P, Buyan L, Sheth RD (2000) Status epilepticus associated with cefepime. Neurology 54:2153–2155
Martínez-Rodríguez JE, Barriga FJ, Santamaria J, Iranzo A, Pareja JA, Revilla M, Rosa CR dela (2001) Nonconvulsive status epilepticus associated with cephalosporins in patients with renal failure. Am J Med 111:115–119
Fishbain JT, Monahan TP, Canonico MM (2000) Cerebral manifestations of cefepime toxicity in a dialysis patient. Neurology 55:1756–1757
Chow KM, Wong TYH, Szeto CC, Li PKT (2002) Nonconvulsive status epilepticus in dialysis patients. Am J Kidney Dis 39:440–441
Nechyba C, Gunn VL (2002) Drugs in renal failure. The Harriet Lane Handbook. Gunn VL, Nechyba C (eds) 16th edn. Mosby, Canada, p 940
Manian FA, Stone WJ, Alford RH (1990) Adverse antibiotic effects associated with renal insufficiency. Rev Infect Dis 12:236–249
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Alpay, H., Altun, Ö. & Bıyıklı, N.K. Cefepime-induced non-convulsive status epilepticus in a peritoneal dialysis patient. Pediatr Nephrol 19, 445–447 (2004). https://doi.org/10.1007/s00467-003-1333-8
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DOI: https://doi.org/10.1007/s00467-003-1333-8