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Drug-induced aseptic meningitis

Eustachio Nettis1, Gianfranco Calogiuri, Maria Cristina Colanardi

  • 1Department of Medical Clinic, Immunology and Infectious Diseases, Division of Allergy and Clinical Immunology, University of Bari, Italy. e.nettis@allergy.uniba.it

Current Drug Targets. Immune, Endocrine and Metabolic Disorders
|May 29, 2003
PubMed

Insights

Drug-induced aseptic meningitis (DIAM) is a rare complication of certain medications, presenting with distinct symptoms like fever and headache. While the exact cause is unknown, DIAM typically resolves without long-term effects.

Area of Science:

  • Neurology
  • Pharmacology
  • Immunology

Background:

  • Aseptic meningitis is an infrequent but recognized adverse effect of various drug therapies.
  • Drug-induced aseptic meningitis (DIAM) presents with a characteristic set of symptoms including fever, neck stiffness, headache, confusion, nausea, and vomiting.

Purpose of the Study:

  • To review the clinical presentation, causative agents, diagnostic challenges, and outcomes of drug-induced aseptic meningitis.
  • To highlight the importance of considering DIAM in differential diagnoses and the potential role of immunological mechanisms.

Main Methods:

  • Review of literature on drug-induced aseptic meningitis.
  • Analysis of clinical presentations and implicated drug categories (NSAIDs, antimicrobials, IVIg, monoclonal antibodies, vaccines).
  • Discussion of diagnostic approaches, including exclusion of infectious causes and supervised rechallenge.

Main Results:

  • Commonly implicated drugs often trigger DIAM through immunological pathways, though the precise pathogenesis remains unclear.
  • Diagnosis is challenging, requiring exclusion of infectious meningitis and potentially confirmed by medically supervised rechallenge.
  • The prognosis for DIAM is generally favorable, with most patients experiencing a full recovery without lasting sequelae.

Conclusions:

  • Drug-induced aseptic meningitis is a distinct clinical entity with a generally good prognosis.
  • Awareness of causative agents and diagnostic criteria is crucial for timely management.
  • Further research into the pathogenetic mechanisms of DIAM is warranted.

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