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: Heyun Kim, Kon Chu, Keun-Hwa Jung, Soon-Tae Lee, Jeong-Min Kim, Sang Kun Lee
• Journal: Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology (Neurol Sci) Vol. 33 Issue 6 Pg. 1393-6 (Dec 2012) ISSN: 1590-3478 [Electronic] Italy
• PMID: 22258360 (Publication Type: Case Reports, Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Anti-Bacterial Agents
• Cephalosporins
• cefditoren pivoxil
• Carnitine

Topics

• Anti-Bacterial Agents (adverse effects)
• Brain Diseases, Metabolic (chemically induced, diagnosis)
• Cardiomyopathies (chemically induced, diagnosis)
• Carnitine (deficiency)
• Cephalosporins (adverse effects)
• Diagnosis, Differential
• Female
• Humans
• Hyperammonemia (chemically induced, diagnosis)
• Middle Aged
• Muscular Diseases (chemically induced, diagnosis)