Cerebellar toxicity in the form of ataxia and slurring of speech: case reportA 19-year-old man developed cerebellar toxicity in the form of ataxia and slurring of speech during treatment with cytarabine for acute myeloid leukaemia (AML).The man, who was diagnosed with AML, started receiving unspecified antibacterials [antibiotics] and empirical amphotericin-Bliposomal [liposomal amphotericin]. He started receiving nasal oxygen and admitted in the ICU. He was shifted to HEPA filter room following day on nasal oxygen. He received hydroxycarbamide [hydroxyurea]. Further, investigation suggested possible infective endocarditis. Then, amphotericin-B-liposomal was continued and polymyxin B was started empirically. He was noted to have hyperbilirubinaemia. One week following admission, he continued to be hypoxic on supplemental oxygen requirement. Further, he received azacitidine, anidulafungin and venetoclax. Although, he continued to have fever, tachycardia, tachypnoea and worsening liver function tests. Based on findings, hemophagocytic lymphohistiocytosis was suspected. Later, he was treated with hydrocortisone, immune globulin and methylprednisolone. Eventually, his condition improved. Further, methylprednisolone was changed to dexamethasone. The dual antifungal treatment with amphotericin-B-liposomal and anidulafungin completed for 14 days. Based on his continuous improvement, he was discharged. He was found to have presence of mutation in WT1 and PTPN11 genes. Then, he received first cycle consolidation with cytarabine [route and dosage not stated]; however, he developed cerebellar toxicity in the form of ataxia and slurring of speech 24 hours following the last dose of cytarabine.The man was received conservative treatment and a complete recovery with mild slurring of speech was noted. He underwent successful matched sibling allogeneic stem cell transplantation.
