title: Aseptic meningitis associated with chronic sulindac use for osteoarthritis: a case report.
abstract: We report a case of aseptic meningitis thought to be associated with chronic sulindac use in a patient with osteoarthritis. The patient was hospitalized with an acute onset of headache, nuchal rigidity, nausea, and blurred vision. Brain imaging was unremarkable and a lumbar puncture revealed a lymphocytic pleocytosis. No infectious source was identified. The patient reported taking sulindac over the past year, it was discontinued, and symptoms promptly resolved. This case underscores the importance of obtaining a thorough drug history in conjunction with the knowledge of causative medications associated with aseptic meningitis. Given the widespread use of nonsteroidal anti-inflammatory drugs, clinicians must recognize that aseptic meningitis is a possible adverse effect of these medications.
authors: College of Pharmacy, Southwestern Oklahoma State University, Weatherford, OK 73096-3098, USA. erin.callen@swosu.edu
authors: Erin C
authors: EC
authors: Callen
authors: Chelsea O
authors: CO
authors: Church
authors: Manish
authors: M
authors: Patel
authors: Tiffany L
authors: TL
authors: Sikes
mesh_terms: D000368:Aged; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000009:adverse effects*; D006801:Humans; D008297:Male; D008582:Meningitis, Aseptic / Q000139:chemically induced*; D010003:Osteoarthritis / Q000188:drug therapy*; D012307:Risk Factors; D013467:Sulindac / Q000009:adverse effects*
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D013467:Sulindac
references: Ann Intern Med. 1980 Feb;92(2 Pt 1):206-7
references: 7352728
references: Arch Intern Med. 1982 Jan;142(1):165-6
references: 7053720
references: Medicina (B Aires). 1991;51(2):186
references: 1820511
references: Ann Pharmacother. 2004 Jan;38(1):172
references: 14742817
references: Medicine (Baltimore). 2006 Jul;85(4):214-20
references: 16862046
references: Arch Intern Med. 1999 Jun 14;159(11):1185-94
references: 10371226
references: Postgrad Med J. 2003 May;79(931):295-6
references: 12782779
references: Am J Med. 1987 Apr;82(4):817-20
references: 3565435
references: JAMA. 1981 Jan 2;245(1):67-8
references: 7431632
references: JAMA. 1978 Mar 13;239(11):1062-4
references: 304902
references: Clin Pharmacol Ther. 1981 Aug;30(2):239-45
references: 7249508
references: Arthritis Rheum. 1991 Oct;34(10):1340-1
references: 1930326
references: South Med J. 1988 Nov;81(11):1463-4
references: 3187641
references: Arch Intern Med. 2002 Mar 25;162(6):713-5
references: 11911727
references: Drug Intell Clin Pharm. 1988 May;22(5):399-401
references: 3391111