日本口腔外科学会雑誌
Online ISSN : 2186-1579
Print ISSN : 0021-5163
ISSN-L : 0021-5163
症例報告
腎機能の低下した口腔癌患者の化学放射線療法中に生じたセフェピムによる抗菌薬関連脳症の1例
中嶋 光平山 真敏山下 真柚子関 祐紀大山 徹中山 秀樹
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2026 年 72 巻 3 号 p. 197-203

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 Antimicrobial-associated epilepsy (AAE) is a drug-induced encephalopathy in which antimicrobial agents cause neurological symptoms such as impaired consciousness, aphasia, involuntary movements, and epileptic seizures. We report a case of AAE caused by cefepime (CFPM) in an oral cancer patient treated with chemoradiotherapy (CRT). A 72-year-old man was referred to our department complaining of swelling and pain in his oral floor. We diagnosed the patient with oral floor squamous cell carcinoma (cT4aN2cM0), and decided to perform CRT with carboplatin because of impaired renal function. During CRT, febrile neutropenia was observed and CFPM was administered. Four days after initiation of CFPM, the patient presented with impaired consciousness, aphasia, seizures, and an abnormal electroencephalogram. Finally, the patient was diagnosed with AAE, and the symptoms disappeared shortly after withdrawal of CFPM. AAE should be considered in patients who develop impaired consciousness while receiving antimicrobial therapy. In patients with impaired renal function, antimicrobial doses should be carefully determined to prevent the development of AAE.
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