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Randrianarisoa RMF, Raulin O, Merlin A, Tonnelier M, Lecapitaine AL. A Case of Confusion in an Obese Patient Treated With Daptomycin: Neurotoxicity. Cureus 2024; 16:e62254. [PMID: 39006728 PMCID: PMC11245046 DOI: 10.7759/cureus.62254] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/12/2024] [Indexed: 07/16/2024] Open
Abstract
Daptomycin (DAP) is a cyclic lipopeptide antibiotic with bactericidal activity against gram-positive bacteria. The most common adverse reaction is myotoxicity characterized by rhabdomyolysis. Other reported adverse reactions include gastrointestinal symptoms, skin lesions, bleeding, and pulmonary involvement. Neurotoxicity is rare and its mechanism remains partially elucidated. We report a case of confusion consistent with DAP-induced neurotoxicity. A 73-year-old obese man was treated with DAP 9 mg/kg for methicillin-resistant Staphylococcus aureus (MRSA) bacteremia associated with foot osteitis and cervical posterior inter-apophyseal arthritis. On the fifth day of treatment, he developed spatial disorientation, and serum DAP concentrations were very high. DAP-induced neurotoxicity was suggested. His neurological status returned to normal after treatment was stopped. This observation describes a relationship between confusion and DAP that is favored by obesity. Clinicians should be alert for neurologic disorders associated with DAP. It is prudent to reduce doses in obese patients.
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Affiliation(s)
| | - Olivia Raulin
- Medical Biology, Compiègne-Noyon Hospital, Compiègne, FRA
| | - Anthony Merlin
- Internal Use Pharmacy, Compiègne-Noyon Hospital, Compiègne, FRA
| | - Mathilde Tonnelier
- Infectious and Tropical Diseases, Compiègne-Noyon Hospital, Compiègne, FRA
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León-Andrino A, Noriega DC, Lapuente JP, Pérez-Valdecantos D, Caballero-García A, Herrero AJ, Córdova A. Biological Approach in the Treatment of External Popliteal Sciatic Nerve (Epsn) Neurological Injury: Review. J Clin Med 2022; 11:2804. [PMID: 35628928 PMCID: PMC9144828 DOI: 10.3390/jcm11102804] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Revised: 05/10/2022] [Accepted: 05/11/2022] [Indexed: 11/17/2022] Open
Abstract
The external popliteal sciatic nerve (EPSN) is the nerve of the lower extremity most frequently affected by compressive etiology. Its superficial and sinuous anatomical course is closely related to other rigid anatomical structures and has an important dynamic neural component. Therefore, this circumstance means that this nerve is exposed to multiple causes of compressive etiology. Despite this fact, there are few publications with extensive case studies dealing with treatment. In this review, we propose to carry out a narrative review of the neuropathy of the EPSN, including an anatomical reminder, its clinical presentation and diagnosis, as well as its surgical and biological approach. The most novel aspect we propose is the review of the possible role of biological factors in the reversal of this situation.
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Affiliation(s)
- Alejandro León-Andrino
- Department of Orthopedic Surgery, Clinic University Hospital of Valladolid, 47005 Valladolid, Spain;
| | - David C. Noriega
- Department of Orthopedic Surgery, Clinic University Hospital of Valladolid, 47005 Valladolid, Spain;
- Department of Surgery, Ophthalmology, Otorhinolaryngology and Physiotherapy, Faculty of Medicine, University of Valladolid, 47005 Valladolid, Spain
| | - Juan P. Lapuente
- SCO (Scientific Chief Officer) Laboratorio de Biología Molecular y Celular R4T, University Hospital of Fuenlabrada, 28942 Fuenlabrada, Spain;
| | - Daniel Pérez-Valdecantos
- Biochemistry, Molecular Biology and Physiology, Faculty of Health Sciences, GIR Physical Exercise and Aging, University of Valladolid, Campus Duques de Soria, 42004 Soria, Spain; (D.P.-V.); (A.C.)
| | - Alberto Caballero-García
- Department of Anatomy and Radiology, Faculty of Health Sciences, GIR Physical Exercise and Aging, University of Valladolid, Campus Duques de Soria, 42004 Soria, Spain;
| | - Azael J. Herrero
- Department of Health Sciences, Miguel de Cervantes European University, 47012 Valladolid, Spain;
| | - Alfredo Córdova
- Biochemistry, Molecular Biology and Physiology, Faculty of Health Sciences, GIR Physical Exercise and Aging, University of Valladolid, Campus Duques de Soria, 42004 Soria, Spain; (D.P.-V.); (A.C.)
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Coraci D, Giovannini S, Loreti C, Padua L. Ulnar neuropathy after glatiramer acetate subcutaneous injection: Ultrasound findings. J Clin Pharm Ther 2018; 44:140-141. [PMID: 30315577 DOI: 10.1111/jcpt.12773] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
| | - Silvia Giovannini
- Rehabilitation Units, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | | | - Luca Padua
- IRCCS Fondazione Don Carlo Gnocchi, Milan, Italy.,Department of Geriatrics, Neurosciences and Orthopaedics, Università Cattolica del Sacro Cuore, Rome, Italy
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