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Drug-induced aseptic meningitis after amoxicillin use

Jina Bai1, Todd Cutler

  • 1At NewYork-Presbyterian Weill Cornell Medical Center in New York City, Jina Bai practices hospital medicine and Todd Cutler is an assistant professor. The authors have disclosed no potential conflicts of interest, financial or otherwise.

JAAPA : Official Journal of the American Academy of Physician Assistants
|March 25, 2025
PubMed

Insights

Drug-induced aseptic meningitis (DIAM) is a noninfectious meningitis caused by medications. Symptoms mimic infectious meningitis but resolve upon drug withdrawal, often recurring with re-exposure.

Area of Science:

  • Neurology
  • Pharmacology
  • Infectious Diseases

Background:

  • Drug-induced aseptic meningitis (DIAM) is a noninfectious inflammatory condition of the meninges.
  • Diagnosis relies on excluding infectious causes and observing symptom resolution after drug cessation.
  • Recurrence is common upon re-exposure to the causative agent.

Purpose of the Study:

  • To describe a case of drug-induced aseptic meningitis.
  • To highlight amoxicillin as a potential cause of DIAM.
  • To emphasize the diagnostic challenges and clinical presentation of DIAM.

Main Methods:

  • Literature review of drug-induced aseptic meningitis.
  • Clinical case presentation of a patient with meningoencephalitis.
  • Analysis of diagnostic criteria and treatment outcomes for DIAM.

Main Results:

  • The patient presented with meningoencephalitis following prophylactic amoxicillin use.
  • Clinical features were indistinguishable from infectious meningitis.
  • Symptoms improved rapidly after amoxicillin discontinuation.

Conclusions:

  • Amoxicillin can cause drug-induced aseptic meningitis.
  • DIAM diagnosis requires careful exclusion of infections and consideration of drug history.
  • Prompt recognition and drug withdrawal are crucial for patient recovery.

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