Ceftazidime Overdose-Related Nonconvulsive Status Epilepticus After Intraperitoneal Instillation

Abstract

We report a case of ceftazidime-related nonconvulsive status epilepticus (NCSE) in a 70-year-old female patient with continuous ambulatory peritoneal dialysis (CAPD)-related peritonitis. She was given ceftazidime intravenously which was then changed to intraperitoneal installation after clinical improvement. She received 11 g of ceftazidime via intraperitoneal installation for two days after being discharged from the hospital. Her consciousness was altered with mutism, asterisxis, and horizontal nystagmus. Her EEG showed continuous generalized three spikes-and-wave per second that were abolished after intravenous diazepam. Ceftazidime-related NCSE was suggested and ceftazidime therapy was stopped. Hemodialysis was done while phenytoin was also given to control the convulsions. Her consciousness improved after hemodialysis. Serum ceftazidime measured before and after hemodialysis on the second and third day were 105.2/39.4, 36.2/5.2 μg/mL (normal peak level 55 μg/mL), respectively. Repeated evaluation on day 6 showed normal EEG without epileptiform activity. She was later discharged with full recovery.

Keywords :

• Ceftazidime
• Nonconvulsive status epilepticus
• Intraperitoneal instillation