title: [Bupivacaine induced aseptic meningitis].
abstract: BACKGROUND
  Drug-induced aseptic meningitis (DIAM) is an uncommon adverse reaction secondary to the administration of numerous agents. It is diagnosed by exclusion, and its outcome is generally excellent with complete long term recovery. There are few reports of DIAM associated to intrathecal administration of bupivacaine in the literature.
  
  
  METHODS
  We present a 16 year-old male patient who received spinal anaesthesia with 10 mg of bupivacaine prior to orthopedic surgery. A few hours later he complained of headache followed by confusion and stupor. A TC scan of the brain was normal. Diagnostic lumbar puncture revealed cloudy cerebrospinal fluid (CSF) with increased polymorphonuclear, increased protein and decreased glucose concentrations. Immediate treatment with antibiotics and corticosteroids was instituted and the patient rapidly recovered without sequelae. Blood and CSF cultures were negative, antibiotics were suspended and corticosteroids tapered.
  
  
  CONCLUSIONS
  To the best of our knowledge, we report a case of bupivacaine induced aseptic meningitis.
authors.affiliation: Serviciio de Neurología, Hospital Privado de Comunidad, Mar de Plata (Argentina). agbesocke@sna.org.ar
authors.forename: A G
authors.initials: AG
authors.lastname: Besocke
authors.forename: R
authors.initials: R
authors.lastname: Santamarina
authors.forename: L Martín
authors.initials: LM
authors.lastname: Romano
authors.forename: R Alfredo
authors.initials: RA
authors.lastname: Femminini
mesh_terms: D000293:Adolescent; D000775:Anesthesia, Spinal / Q000009:adverse effects*; D000779:Anesthetics, Local / Q000009:adverse effects* / Q000493:pharmacokinetics; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D002045:Bupivacaine / Q000009:adverse effects* / Q000493:pharmacokinetics; D002555:Cerebrospinal Fluid / Q000166:cytology; D003907:Dexamethasone / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D050723:Fractures, Bone / Q000601:surgery; D006801:Humans; D007964:Leukocytosis / Q000209:etiology; D008297:Male; D008582:Meningitis, Aseptic / Q000134:cerebrospinal fluid / Q000139:chemically induced* / Q000175:diagnosis / Q000188:drug therapy; D008682:Metatarsal Bones / Q000293:injuries / Q000601:surgery; D009504:Neutrophils; D011183:Postoperative Complications / Q000139:chemically induced* / Q000175:diagnosis
chemical_list: D000779:Anesthetics, Local; D000900:Anti-Bacterial Agents; D003907:Dexamethasone; D002045:Bupivacaine