Amoxicillin-induced aseptic meningitis: case report and review of published cases

Turk, Viktorija Erdeljić; Šimić, Iveta; Makar-Aušperger, Ksenija; Radačić-Aumiler, Matea

doi:10.5414/cp202645

Cited by 9 publications

(17 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The clinical manifestations of AIAM are typical for meningoencephalitis, including fever, headache, neck stiffness with or without objective meningismus, cognitive changes, and related neurological signs. 1,2 Our patient's presentation was therefore similar to previous reports. Given the nonspecific signs and symptoms, the differential diagnosis for recurrent meningitis is broad.…”

supporting

confidence: 90%

“…Theories suggest an immune-mediated hypersensitivity reaction or direct meningeal irritation. 1 The former has been supported by the detection of serum immune complexes in the CSF of some patients with DIAM caused by drugs other than amoxicillin. However, one report of AIAM tested serum and CSF for immunoglobulin E to amoxicillin and immune complexes interacting with C1q and did not provide any evidence supporting a type 1 or 3 hypersensitivity reaction.…”

mentioning

confidence: 94%

“…[1][2][3] AIAM is extremely rare, and have been previously reported only 13 times. 1 As with most cases of DIAM, AIAM is a diagnosis of exclusion. The first episode is not usually attributed to amoxicillin, and many cases likely go undiagnosed.…”

mentioning

confidence: 99%

“…All of the published cases of AIAM, including our own, document a positive rechallenge with amoxicillin. 1 The pathogenesis of DIAM remains elusive. Theories suggest an immune-mediated hypersensitivity reaction or direct meningeal irritation.…”

mentioning

confidence: 99%

See 3 more Smart Citations

Recurrent Amoxicillin-Induced Aseptic Meningitis

Chu

Eustace

2018

Can. J. Neurol. Sci.

View full text Add to dashboard Cite

supporting

confidence: 90%

mentioning

confidence: 94%

mentioning

confidence: 99%

mentioning

confidence: 99%

See 2 more Smart Citations

Recurrent Amoxicillin-Induced Aseptic Meningitis

Chu

Eustace

2018

Can. J. Neurol. Sci.

View full text Add to dashboard Cite

“…Other antimicrobial drugs have been implicated in drug-induced aseptic meningitis [5], for example. amoxicillin [14,52,53], cephalosporins [26,54], rifampicin [28], valacyclovir [55], and ornidazole [56].…”

Section: Antimicrobial Drugsmentioning

confidence: 99%

Drug‐induced aseptic meningitis: a mini‐review

Yéléhé‐Okouma

Czmil-Garon

Pape

et al. 2018

Fundamemntal Clinical Pharma

View full text Add to dashboard Cite

Aseptic meningitis associates a typical clinical picture of meningitis with the absence of bacterial or fungal material in the cerebrospinal fluid. Drug-induced aseptic meningitis (DIAM) may be due to two mechanisms: (i) a direct meningeal irritation caused by the intrathecal administration of drugs and (ii) an immunologic hypersensitivity reaction to a systemic administration. If the direct meningeal irritation allows a rather easy recognition, the immunologic hypersensitivity reaction is a source of challenging diagnostics. DIAM linked to a systemic treatment exerts typically an early onset, usually within a week. This period can be shortened to a few hours in case of drug rechallenge. The fast and spontaneous regression of clinical symptoms is usual after stopping the suspected drug. Apart from these chronological aspects, no specific clinical or biological parameters are pathognomonic. CSF analysis usually shows pleiocytosis. The proteinorachia is increased while glycorachia remains normal. Underlying pathologies can stimulate the occurrence of DIAM. Thus, systemic lupus erythematosus appears to promote DIAM during NSAID therapy, especially ibuprofen-based one. Similarly, some patients with chronic migraine are prone to intravenous immunoglobulin-induced aseptic meningitis. DIAM will be mainly evoked on chronological criteria such as rapid occurrence after initiation, rapid regression after discontinuation, and recurrence after rechallenge of the suspected drug. When occurring, positive rechallenge may be very useful in the absence of initial diagnosis. Finally, DIAM remains a diagnosis of elimination. It should be suggested only after all infectious causes have been ruled out.

show abstract