PT  - JOURNAL ARTICLE
AU  - Philipp Zimmermann
AU  - Dominik Camenzind
AU  - Jürg Hans Beer
AU  - Alexander Andrea Tarnutzer
TI  - Negative myoclonus as the leading symptom in acute cefepime neurotoxicity
AID  - 10.1136/bcr-2020-239744
DP  - 2021 Apr 01
TA  - BMJ Case Reports
PG  - e239744
VI  - 14
IP  - 4
4099  - http://casereports.bmj.com/content/14/4/e239744.short
4100  - http://casereports.bmj.com/content/14/4/e239744.full
SO  - BMJ Case Reports2021 Apr 01; 14
AB  - An 86-year-old woman was diagnosed with hospital-acquired pneumonia with Pseudomonas aeruginosa and treated with cefepime adjusted to her renal clearance. After 4 days, she developed acute-onset negative myoclonus without signs of altered mental status. After ruling out an acute intracranial haemorrhagic or ischaemic stroke as well as other metabolic and endocrine causes of negative myoclonus, the antibiotic was switched to piperacillin/tazobactam due to a suspicion of cefepime neurotoxicity. The patient improved within 24 hours and her symptoms fully resolved within 4 days. These observations suggest a link of the negative myoclonus to acute cefepime neurotoxicity, which may occur without or with minimal alteration of mental status, thus extending its spectrum of clinical presentation.