Case Report
Metronidazole-Induced Pancreatitis: Is There Underrecognition? A Case Report and Systematic Review of the Literature
Table 1
Metronidazole-induced pancreatitis case reports in the English literature.
| | First author, year of study | Gender | Age | Number of Episodes | Indication for use of metronidazole (with each episode) | Interval between metronidazole administration and onset of pancreatitis’ symptoms (per episode) | Serum amylase, level after the onset of pancreatitis’ symptoms (per episode) | Serum lipase level after the onset of pancreatitis’ symptoms (per episode) | Imaging findings for acute pancreatitis (per episode) |
| | Plotnick BH, 1985 | F | 29 | 1
2 | Vaginal discharge | 1 day
38 days | 1182 U/dL
1727 U/dL | 50 U/dL
64 U/dL | N/A
N/A |
| | Sanford KA, 1988 | F | 23 | 1
2
3
4 | Gardnerella vaginalis | 9 days
3-7 days
3-7 days
3-7 days | 19.07 µkal/L
Elevated
Elevated
Elevated | N/A
Elevated
Elevated
Elevated | Positive
N/A
N/A
N/A |
| | Celifarco A, 1989 | F | 22 | 1
2
3 | Vaginal infection | 24 hours
24 hours
12 hours | 250 U/L
280 U/L
1657 U/L | N/A
N/A
52.2 U/L | N/A
N/A
Positive |
| | Corey WA, 1991 | F | 63 | 1 | Crohn’s recurrent rectovaginal fistula | 7 days | 906 U/L | 2148 U/L | Negative |
| | de Jongh FE, 1996 | F | 45 | 1
2
3 | Vaginitis | N/A
N/A
1 day | N/A
N/A
120 U/L | N/A
N/A
N/A | N/A
N/A
Negative |
| | Sura ME, 2000 | F | 61 | 1 | Aspiration pneumonia | 4 days | 566 U/L | 245 U/L | Negative |
| | Feola DJ, 2002 | F | 49 | 1
2 | Trichomoniasis | 3-5 days
12 hours | N/A
1397 U/L | N/A
6916 U/L | N/A
Negative |
| | Nigwekar SU, 2004 | F | 46 | 1
2 | Bacterial vaginosis | 8 days
8 days | N/A
398 U/L | N/A
2543 U/L | N/A
Negative |
| | Tsesmeli NE, 2007 | M | 31 | 1 | Bloody diarrhea with a history of IBD | 3 days | 581 U/L | N/A | Positive |
| | Loulergue P, 2008 | M | 25 | 1 | Pseudomembranous colitis | 5 days | 317 U/L | 665 U/L | N/A |
| | O'Halloran E, 2010 | F | 25 | 1
2 | Periodontal abscess | 3 doses (1 day)
5 doses (2 days) | N/A
810 U/L | N/A
N/A | N/A
N/A |
| | Cabrera R, 2011 | M | 74 | 1 | Acute diverticulitis | 12 hours | 729 U/L | 2250 U/L | Negative |
| | Yousaf H, 2012 | F | 23 | 1 | Trichomoniasis | 1 hour | 327 IU/mL | 876 IU/mL | Positive |
| | Yilmaz M, 2016 | M | 22 | 1
2
3 | Ulcerative colitis
C. difficile colitis | 3 days
2 days
3 days | N/A
387 IU/L
427 IU/L | N/A
400 IU/L
429 IU/L | N/A
N/A
Positive |
| | Our case | F | 60 | 1
2 | C. difficile colitis | 4 days
3 days | N/A
N/A | 808 IU/L
396 IU/L | Positive
Positive |
|
|
N/A: Not applicable.
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