Metronidazole Induced Acute Pancreatitis

Introduction: Pancreatitis is a very rare adverse effect of metronidazole with only eight cases of metronidazole-induced pancreatitis reported so far. Case Report: A 23-year-old African-American female developed acute pancreatitis following treatment with metronidazole for vaginal trichomoniasis. She took metronidazole at two different times and experienced the severe epigastric pain and vomiting one hour after each dose. These episodes were unrelated to alcohol ingestion, gallbladder disease or other known causes of pancreatitis. Laboratory studies revealed elevated amylase and lipase concentrations and CT scan confirmed the findings consistent with acute pancreatitis. After discontinuation of metronidazole, the patient's abdominal pain improved, and both amylase and lipase concentrations immediately declined and were within normal limits after one day. Conclusion: High degree of suspicion is warranted on the part of physicians to diagnose metronidazole induced pancreatitis in patients presenting with gastrointestinal symptoms after metronidazole exposure. We suggest that metronidazole be discontinued when clinical or biochemical features of acute pancreatitis occur, once other known causes of pancreatitis have been excluded and rechallenge should be avoided.

並列關鍵字

Pancreatitis ； Metronidazole ； Drug toxicity

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