We report the case of a 57-year-old man, with no psychiatric history or toxic consumption, who was admitted for upper gastrointestinal bleeding secondary to mild duodenal ulcer clarithromycine, amoxicillin and pautazole treatment for H. pylori with pantoprazole.
Twenty-four hours after admission, the patient presented a self-limiting environment disconnection.
At 36 hours, he began a picture characterized by ideas of harm and aggression toward the health care staff ("would he want to kill", "what do I do not do here?"), rushing out the window of the hospital with intent.
Brain CT and EEG were normal.
The Psychiatry Department suspected clarithromycin by levofloxacin and requested olanzapine, with complete improvement and resolution after 48 hours.
The abrupt onset, characteristics of the episode and clinical improvement after withdrawal of this antibiotic supported the diagnosis of acute psychotic broth of organic origin secondary to clarithromycin.
