A Case of Hemiballism as a Rare Side Effect of Ciprofloxacin in a Patient with Liver Cirrhosis

Background: Ciprofloxacin is commonly used and considered to be relatively safe in patients with cirrhosis, especially in the treatment of enteric and urinary tract infections. Among the adverse effects of ciprofloxacin, neurologic complications are rare. Methods/Results: We report a case of hemiballism and altered mental status after prolonged administration of ciprofloxacin for a renal abscess in a 59-year-old patient with cirrhosis. Hemiballism accompanied by mental changes imposed a diagnostic challenge in the differentiation between hepatic encephalopathy and stroke. Conclusion: Careful dosing and a high index of suspicion of the neurological adverse effects of ciprofloxacin including movement disorders are warranted especially in cirrhotic patients.