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Recurrent amoxicillin-induced aseptic meningitis.

Jasmine Banner1, Kathryn Krulisky2, Elizabeth Frakes2

  • 1School of Medicine, The University of Utah School of Medicine, Salt Lake City, Utah, USA jasmine.banner@hsc.utah.edu.

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|March 25, 2025
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Summary

A rare case of amoxicillin-induced aseptic meningitis occurred in an elderly woman presenting with headache and neck pain. This condition should be considered in patients with similar symptoms following amoxicillin exposure.

Keywords:
Drugs: infectious diseasesGeneral practice / family medicineMeningitisUnwanted effects / adverse reactions

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Area of Science:

  • Neurology
  • Infectious Diseases
  • Pharmacology

Background:

  • Aseptic meningitis is an inflammation of the meninges not caused by bacterial infection.
  • Antibiotic-induced meningitis is a rare but serious adverse drug reaction.
  • Amoxicillin is a commonly prescribed antibiotic with a generally favorable safety profile.

Purpose of the Study:

  • To report a rare case of amoxicillin-induced aseptic meningitis.
  • To highlight the diagnostic challenges and management of this condition.
  • To increase awareness among clinicians regarding this potential adverse drug reaction.

Main Methods:

  • Case report of a woman in her 70s presenting with meningoencephalitis symptoms.
  • Clinical examination, laboratory tests (including cerebrospinal fluid analysis), and CT imaging were performed.
  • Patient history of amoxicillin exposure and response to treatment were crucial.

Main Results:

  • The patient presented with headache, sore throat, and neck pain, initially treated for a tonsillar abscess.
  • Cerebrospinal fluid analysis revealed lymphocytosis and elevated protein, suggestive of meningitis.
  • Recurrence of symptoms after Augmentin (amoxicillin) administration confirmed amoxicillin allergy and aseptic meningitis.

Conclusions:

  • Amoxicillin-induced aseptic meningitis is a rare diagnosis that should be considered in patients with non-specific meningoencephalitis symptoms after amoxicillin exposure.
  • Diagnosis relies on symptom timing relative to amoxicillin exposure and exclusion of other causes.
  • Management involves prompt discontinuation of amoxicillin and supportive care.