Suspected Allopurinol-Induced Aseptic Meningitis
Drug-induced aseptic meningitis is a syndrome with symptoms similar to those of infectious meningitis. A 60-year-old man with a history of recurrent renal stones was admitted to the hospital with fever, chills, and mental status changes after taking levofloxacin, allopurinol, and acetazolamide. No infectious source was identified. Once home, he resumed allopurinol, and within 2 hours, he experienced the same symptoms, requiring rehospitalization. He was diagnosed with suspected meningitis from an adverse drug reaction that we believe was due to allopurinol. It is important to remember, when all other causes are ruled out, that a patient's symptoms may be a drug-induced adverse effect. Drug-induced aseptic meningitis should be considered when patients with symptoms similar to those of infectious meningitis appear without infectious etiologies or cerebrospinal fluid pleocytosis, a suspected agent was recently started, and resolution of adverse effects occurs when the agent is withdrawn.
Drug-induced aseptic meningitis is a syndrome with symptoms similar to infectious meningitis, including headache, fever, meningism, and mental status changes. Several agents have been associated with this syndrome. Among the most common are antibiotics, nonsteroidal antiinflam-matory drugs, intravenous immunoglobulins, and OKT3 monoclonal antibodies. An extensive review of the literature from January 1966-August 1999 using the MEDLINE database revealed no reported cases of allopurinol-induced aseptic meningitis.
Drug-induced aseptic meningitis is a syndrome with symptoms similar to those of infectious meningitis. A 60-year-old man with a history of recurrent renal stones was admitted to the hospital with fever, chills, and mental status changes after taking levofloxacin, allopurinol, and acetazolamide. No infectious source was identified. Once home, he resumed allopurinol, and within 2 hours, he experienced the same symptoms, requiring rehospitalization. He was diagnosed with suspected meningitis from an adverse drug reaction that we believe was due to allopurinol. It is important to remember, when all other causes are ruled out, that a patient's symptoms may be a drug-induced adverse effect. Drug-induced aseptic meningitis should be considered when patients with symptoms similar to those of infectious meningitis appear without infectious etiologies or cerebrospinal fluid pleocytosis, a suspected agent was recently started, and resolution of adverse effects occurs when the agent is withdrawn.
Drug-induced aseptic meningitis is a syndrome with symptoms similar to infectious meningitis, including headache, fever, meningism, and mental status changes. Several agents have been associated with this syndrome. Among the most common are antibiotics, nonsteroidal antiinflam-matory drugs, intravenous immunoglobulins, and OKT3 monoclonal antibodies. An extensive review of the literature from January 1966-August 1999 using the MEDLINE database revealed no reported cases of allopurinol-induced aseptic meningitis.
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