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[Recurrent aseptic meningitis secondary to taking ibuprofen and ketorolac]

E Cano Vargas-Machuca1, B Mondéjar-Marín, S Navarro-Muñoz

  • 1Servicio de Neurología, Hospital Virgen de la Salud, Toledo, Spain. efcanovm@yahoo.es

Revista De Neurologia
|March 8, 2006
PubMed
Abstract

Insights

Recurrent aseptic meningitis can be triggered by non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen and ketorolac. Prompt diagnosis and drug withdrawal are crucial for managing this condition, which mimics infectious meningitis.

Area of Science:

  • Neurology
  • Pharmacology
  • Immunology

Background:

  • Aseptic meningitis is meningeal inflammation without infection, often linked to autoimmune conditions or medications.
  • Non-steroidal anti-inflammatory drugs (NSAIDs) are known causes of drug-induced aseptic meningitis.

Observation:

  • A 70-year-old male experienced recurrent meningitis episodes over 16 months.
  • Cerebrospinal fluid analysis revealed polymorphonuclear pleocytosis, high protein, and normal glucose.
  • No infectious, autoimmune, or malignant causes were identified.

Findings:

  • The patient's meningitis episodes correlated with ibuprofen and ketorolac use.
  • Discontinuation of these NSAIDs led to rapid symptom resolution.
  • This case highlights ketorolac as a potential, previously unreported, inducer of aseptic meningitis.

Implications:

  • Aseptic meningitis symptoms can be indistinguishable from infectious meningitis.
  • Diagnosis requires excluding other causes and a thorough medication history, including over-the-counter NSAIDs.
  • Identifying and withdrawing the causative NSAID provides an effective treatment for drug-induced aseptic meningitis.

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