University of Wisconsin–Madison Medical College of Wisconsin

Case Report of Metronidazole-Induced Encephalopathy

Adam Clements, DO

WMJ. 2017;116(4):265-267.

Download full text pdf.


This report describes the case of an 83-year-old woman who was admitted to a hospitalist service with weakness and falls. She was transferred from an outside facility where she was treated with 3 courses of metronidazole for diagnosed Clostridium difficile colitis and presumed reoccurrences. Magnetic resonance imaging (MRI) demonstrated T2 enhancement of the dorsal pons and dentate nuclei consistent with metronidazole-induced encephalopathy. Her metronidazole was stopped and her symptoms resolved. This condition is rare, poorly understood, and causes reversible changes in the brain that are detectable through T2-weighted MRI. It will need ongoing study with current widespread use of metronidazole.

Author Affiliation: Aspirus Wausau Hospital, Wausau, Wis.
Corresponding Author: Adam Clements, DO, Aspirus Wausau Hospital, 333 Pine Ridge Blvd, Wausau, WI 54401; phone/fax 715.203.1260, email
Funding/Support: None declared.
Financial Disclosures: None declared.
Share WMJ