Drug-induced aseptic meningitis: Difference between revisions
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Created page with "== Background == === Etiologies === * NSAIDs: '''ibuprofen''' (most common), diclofenac, naproxen, sulindac * Antibiotics: cotrimoxazole, cephalosporins, amoxicillin, ciprofloxacin * Antiepileptics: lamotrigine, carbamazepine * Chemotherapy: cetuximab, intrathecal chemotherapy * Immunosuppression: methotraxate, azathioprine, TNF-alpha inhibitors (adalimumab, infliximab, etanercept) * Other: [..." |
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Latest revision as of 15:50, 18 September 2025
Background
Etiologies
- NSAIDs: ibuprofen (most common), diclofenac, naproxen, sulindac
- Antibiotics: cotrimoxazole, cephalosporins, amoxicillin, ciprofloxacin
- Antiepileptics: lamotrigine, carbamazepine
- Chemotherapy: cetuximab, intrathecal chemotherapy
- Immunosuppression: methotraxate, azathioprine, TNF-alpha inhibitors (adalimumab, infliximab, etanercept)
- Other: IVIg
Clinical Presentation
- Most commonly associated with ibuprofen, particularly in the context of underlying rheumatologic disease (particularly SLE)
- Onset of headache, fever, and meningismus within 48 hours of drug exposure, and resolution on withdrawal of drug
- Recurs with repeated exposure to the drug
- CSF shows neutrophilic or lymphocytic pleocytosis, elevated protein, and normal glucose
Diagnosis
- Clinical suspicion, with exclusion of other causes
Management
- Avoidance of the offending medication
