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Aseptic meningitis associated with chronic sulindac use for osteoarthritis: a case report

Erin C Callen1, Chelsea O Church, Manish Patel

  • 1College of Pharmacy, Southwestern Oklahoma State University, Weatherford, OK 73096-3098, USA. erin.callen@swosu.edu

Rheumatology International
|August 19, 2007
PubMed

Insights

Aseptic meningitis can be a rare side effect of chronic sulindac use, a nonsteroidal anti-inflammatory drug. Prompt symptom resolution after discontinuing sulindac highlights the importance of drug history in diagnosing meningitis.

Area of Science:

  • Neurology
  • Rheumatology
  • Pharmacology

Background:

  • Osteoarthritis is a common condition often managed with nonsteroidal anti-inflammatory drugs (NSAIDs).
  • NSAIDs, including sulindac, are widely prescribed for pain and inflammation.
  • Aseptic meningitis is a rare but serious neurological complication associated with certain medications.

Observation:

  • A patient with osteoarthritis presented with acute headache, nuchal rigidity, nausea, and blurred vision.
  • Cerebral imaging showed no abnormalities.
  • Lumbar puncture revealed lymphocytic pleocytosis, with no infectious etiology identified.

Findings:

  • The patient's symptoms resolved rapidly after the discontinuation of chronic sulindac use.
  • This clinical course strongly suggests a causal link between sulindac and the aseptic meningitis.
  • No infectious cause for the meningitis was detected.

Implications:

  • Clinicians should consider aseptic meningitis in patients presenting with meningitis symptoms, especially those on NSAIDs.
  • A detailed medication history, including duration of use, is crucial for diagnosing drug-induced aseptic meningitis.
  • Recognizing sulindac and other NSAIDs as potential causes can prevent diagnostic delays and ensure appropriate management.

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