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Antibiotic induced meningitis
Y River1, L Averbuch-Heller, M Weinberger
1Department of Neurology, Hadassah University Hospital, Hebrew University, Jerusalem, Israel.
Abstract:
Three patients with antibiotic induced meningitis, one following penicillin with seven episodes, are reported on--the first well documented description of penicillin induced meningitis. In this patient episodes of headache and nuchal rigidity appeared with and without CSF pleocytosis. Two patients had a total of five episodes of antibiotic induced meningitis after trimethoprim-sulphamethoxazole (co-trimoxazole) administration. The features common to all three patients were myalgia, confusion and low CSF glucose. CSF analysis was not a reliable method to differentiate antibiotic induced meningitis from partially treated bacterial meningitis.
Insights
This study details antibiotic-induced meningitis, a rare condition. Penicillin and trimethoprim-sulfamethoxazole can cause meningitis with symptoms like myalgia and confusion, making CSF analysis unreliable for diagnosis.
Area of Science:
- Neurology
- Infectious Diseases
- Pharmacology
Background:
- Antibiotic-induced meningitis is a rare but significant adverse drug reaction.
- Previous literature on this condition is limited, particularly regarding specific antibiotics.
Observation:
- Reported are three patients experiencing antibiotic-induced meningitis.
- One patient had recurrent meningitis following penicillin administration.
- Two patients experienced meningitis after trimethoprim-sulfamethoxazole (co-trimoxazole).
Findings:
- Common symptoms included myalgia, confusion, and low cerebrospinal fluid (CSF) glucose.
- Penicillin-induced meningitis was documented for the first time.
- CSF analysis was unreliable in differentiating from partially treated bacterial meningitis.
Implications:
- Highlights the potential for antibiotics to cause meningitis.
- Suggests clinicians should consider drug-induced meningitis in differential diagnosis.
- Emphasizes the need for careful patient monitoring during antibiotic therapy.