colistin and Coma

Topics: Acinetobacter baumannii; Acinetobacter Infections; Adolescent; Anti-Bacterial Agents; Brain Injuries, Traumatic; Cerebrospinal Fluid Shunts; Colistin; Coma; Craniotomy; Cross Infection; Drug Resistance, Multiple, Bacterial; Humans; Male; Meningitis, Bacterial; Postoperative Complications; Tigecycline

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.

Topics: Anti-Bacterial Agents; Apnea; Brain Stem; Colistin; Coma; Humans; Kidney Diseases; Male; Middle Aged; Neuromuscular Diseases; Neurotoxicity Syndromes

Topics: Acute Kidney Injury; Adult; Aged; Ascites; Blood Transfusion; Blood Urea Nitrogen; Blood Volume Determination; Colistin; Coma; Diuretics; Drinking Behavior; Female; Furosemide; Humans; Hypokalemia; Injections, Intravenous; Liver Cirrhosis; Male; Middle Aged; Natriuresis; Sodium; Spironolactone; Triamterene; Urea; Water Intoxication; Water-Electrolyte Balance

Topics: Anti-Bacterial Agents; Anticonvulsants; Brain Diseases; Burns; Child; Colistin; Coma; Drug Therapy; Electroencephalography; Humans; Neurologic Manifestations; Seizures

Topics: Anti-Bacterial Agents; Bacteriological Techniques; Cerebrospinal Fluid; Chloramphenicol; Colistin; Coma; Diagnosis; Epidemiology; Erythromycin; Listeria; Listeria monocytogenes; Meningitis; Meningitis, Listeria; Novobiocin; Oleandomycin; Oxytetracycline; Penicillins; Seizures; Sepsis; Serologic Tests; Spiramycin; Sulfonamides; Tetracycline

Topics: Colistin; Coma; Electroencephalography; Humans; Hydrocortisone; Myxedema; Norepinephrine; Oxygen Inhalation Therapy; Penicillins; Resuscitation; Streptomycin; Thyroxine