title: Suspected allopurinol-induced aseptic meningitis.
abstract: 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fluid pleocytosis, a suspected agent was recently started, and resolution of adverse effects occurs when the agent is withdrawn.
authors.affiliation: Department of Pharmacy Services, Ben Taub General Hospital, Houston, Texas 77030, USA.
authors.forename: L E
authors.initials: LE
authors.lastname: Greenberg
authors.forename: T
authors.initials: T
authors.lastname: Nguyen
authors.forename: S M
authors.initials: SM
authors.lastname: Miller
mesh_terms: D000493:Allopurinol / Q000009:adverse effects* / Q000627:therapeutic use; D003937:Diagnosis, Differential; D004791:Enzyme Inhibitors / Q000009:adverse effects* / Q000627:therapeutic use; D006801:Humans; D007669:Kidney Calculi / Q000188:drug therapy; D008297:Male; D008582:Meningitis, Aseptic / Q000139:chemically induced* / Q000175:diagnosis; D016920:Meningitis, Bacterial / Q000175:diagnosis; D008875:Middle Aged; D014969:Xanthine Oxidase / Q000037:antagonists & inhibitors
chemical_list: D004791:Enzyme Inhibitors; D000493:Allopurinol; D014969:Xanthine Oxidase