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[Drug-induced aseptic meningitis]
1Centre de Pharmacovigilance et Centre Anti-Poisons, Hôpital Fernand Widal, Paris.
Abstract:
Aseptic meningitis is a very rare drug reaction involving non-steroidal antiinflammatory agents (ibuprofen and sulindac), antibiotics (cotrimoxazole, trimethoprim, ciprofloxacin) and miscellaneous drugs such as carbamazepine, human immune globulin and muromonab CD3. Meningeal symptoms occur a few hours after drug intake and resolve without sequelae within one or two days after drug withdrawal, mainly in young females with systemic lupus erythematosus or mixed connective tissue disease. Biological findings and radiological investigations are not suggestive of an infectious etiology or rheumatological/neurological disturbances. Diagnosis is simple when recurrent episodes coincide with drug ingestion.
Insights
Aseptic meningitis is a rare drug reaction, often linked to NSAIDs and antibiotics, primarily affecting young women with autoimmune conditions. Symptoms resolve quickly after discontinuing the causative medication.
Area of Science:
- Pharmacology
- Neurology
- Rheumatology
Context:
- Aseptic meningitis is an uncommon adverse drug reaction.
- It is associated with various medications including NSAIDs, antibiotics, and others.
- Patients are typically young females with underlying autoimmune diseases like lupus.
Purpose:
- To describe the clinical presentation, diagnostic features, and causative agents of drug-induced aseptic meningitis.
- To highlight the diagnostic challenges and resolution patterns of this rare condition.
Summary:
- Drug-induced aseptic meningitis presents with meningeal symptoms hours after drug intake.
- Commonly implicated drugs include non-steroidal anti-inflammatory agents (NSAIDs), antibiotics, and miscellaneous agents.
- Resolution is typically rapid and without sequelae upon drug withdrawal.
- Diagnosis is aided by recurrent episodes correlating with drug ingestion, with no infectious or rheumatological findings.
Impact:
- Enhances understanding of rare drug reactions and their clinical manifestations.
- Aids clinicians in diagnosing and managing aseptic meningitis in susceptible patient populations.
- Contributes to pharmacovigilance by identifying specific drug triggers and associated patient profiles.