Q: After few minutes of getting first dose of Metronidazole, patient developed tachycardia, fever, shivering, sweating, dilated pupils, twitching, hyper-reflexia, hyperthermia. Patient became confused, agitated and hypertensive. Your concern?
Answer: Serotonin Syndrome from metronidazole
Symptoms of Serotonin syndrom has been reported with metronidazole. Treatment is discontinuation of drug and supportive treatment.
Karamanakos, P. N. (2008). "The possibility of serotonin syndrome brought about by the use of metronidazole". Minerva Anestesiologica 74(11): 679.