Drug-induced aseptic meningitis.
Aseptic meningitis is a rare but well-recognized complication of drug therapy. The clinical presentation of drug-induced aseptic meningitis (DIAM) is distinct. Symptoms typically include fever, neck stiffness, headache, confusion, nausea and vomiting. The major categories of causative agents are non-steroidal anti-inflammatory drugs, antimicrobials and also intravenous immunoglobulins, monoclonal antibodies and vaccines. These drugs most commonly implicated as causes of aseptic meningitis act more likely through an immunological mechanisms. However, the exact pathogenetic mechanism of DIAM is still unknown. The diagnosis of drug-induced aseptic meningitis is difficult and infectious etiologies must be excluded. In some cases the diagnosis has been confirmed by rechallenging the patient with the suspected agent. In this case, informed written consent is necessary and rechallenge must be medically supervised both to document the response and to offer medical care and advice, if required. The outcome of DIAM is generally good, usually without long term sequelae.
Nettis
Eustachio
E
Department of Medical Clinic, Immunology and Infectious Diseases, Division of Allergy and Clinical Immunology, University of Bari, Italy. e.nettis@allergy.uniba.it
Calogiuri
Gianfranco
G
Colanardi
Maria Cristina
MC
Ferrannini
Antonio
A
Tursi
Alfredo
A
D000276:Adjuvants, Immunologic / Q000009:adverse effects; D000818:Animals; D000900:Anti-Bacterial Agents / Q000009:adverse effects; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000009:adverse effects; D000911:Antibodies, Monoclonal / Q000009:adverse effects; D006801:Humans; D016756:Immunoglobulins, Intravenous / Q000009:adverse effects; D008582:Meningitis, Aseptic / Q000139:chemically induced* / Q000175:diagnosis / Q000276:immunology; D014612:Vaccines / Q000009:adverse effects
D000276:Adjuvants, Immunologic; D000900:Anti-Bacterial Agents; D000894:Anti-Inflammatory Agents, Non-Steroidal; D000911:Antibodies, Monoclonal; D016756:Immunoglobulins, Intravenous; D014612:Vaccines