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Metronidazole is a widely used antibacterial and antiprotozoal agent for a number of conditions. Whilst its more common gastrointestinal side effects are well known, neurotoxicity remains under-recognised. Both central and peripheral neurological side effects have been described. This report describes a case of radiologically confirmed metronidazole-induced cerebellar ataxia in a cirrhotic patient with a review of the literature. Awareness of this side effect is essential for prompt recognition as early drug withdrawal leads to resolution in the majority of cases. [ABSTRACT FROM AUTHOR]

Introduction: What is palliative care and what are its essential elements? Palliative care is an approach that improves the quality of life of patients and their families facing the problem associated with life-threatening illness, through the prevention, treatment and relief of suffering by means of early identification and impeccable assessment and treatment of pain and other problems, physical, psychosocial or spiritual. Under normal circumstances, the clinician's mandate is the restoration of a patient's health and well-being which begins with obtaining a medical history, the examination of the patient, the formulation of a probable diagnosis, investigation, the start of remedial therapy, the monitoring of the response, a review of laboratory or radiographic data and the confirmation of the diagnosis. This committee recommends the use of the SPICT tool where ART is unlikely to improve outcome, for example, end-stage cancer and irreversible end-organ failure, or where current or future ART is judged by the medical and palliative care team to be futile. Chronic pain, that is, pain lasting >= 3 months, is common in the HIV-infected population and is often the reason for a palliative care consultation.[31] Pain in HIV-infected South Africans is likely to accompany an identifiable clinical cause and the most valuable contribution the HIV and palliative care physician can make to pain management is to identify the cause and treat it. [Extracted from the article]