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Case Reports
. 2025 Mar 29:2025:6650287.
doi: 10.1155/crdi/6650287. eCollection 2025.

Cefepime-Induced Encephalopathy in a Patient With Uncompromised Renal Function: A Case Report

Aayusha Dhakal  1 , Ozone Gautam  2
Affiliations
Case Reports

Cefepime-Induced Encephalopathy in a Patient With Uncompromised Renal Function: A Case Report

Aayusha Dhakal et al. Case Rep Infect Dis. .

Abstract

Cefepime, a fourth-generation cephalosporin, is widely used in the treatment of infections caused by resistant Gram-negative bacteria especially Pseudomonas aeruginosa, or in severe infections, septic shock, and infections in immunocompromised patients. As it crosses the blood-brain barrier, it can cause neurotoxicity which has mostly been reported in patients with impaired renal function. Patients can present with drowsiness, confusion, delirium, agitation, stupor, or coma, and sometimes with generalized myoclonus and seizures within two to six days after starting the antibiotic. This is a rare case report where a patient with intact kidney function presented with confusion and incoherence. After excluding the possible causes for encephalopathy, cefepime-induced encephalopathy was diagnosed and the patient gradually improved after discontinuing the medication. This case is an unusual presentation of symptoms in a patient with normal kidney function, which necessitates further studies to establish other potential risk factors of cefepime-induced neurotoxicity.

Keywords: case report; cefepime-induced neurotoxicity; metabolic encephalopathy; normal renal function; renal dose adjustment.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
Timeline from the initial presentation of the patient's symptoms to their improvement and eventual discharge home.
See this image and copyright information in PMC

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