title: A diagnostic dilemma: drug-induced aseptic meningitis in a 45-year-old HIV-positive man.
abstract: We describe a case of aseptic meningitis following the administration of moxifloxacin in a 45-year-old man with human immunodeficiency virus (HIV). At presentation he was receiving tuberculosis treatment on a modified regimen following severe hepatotoxicity; this included moxifloxacin, started 8 days previously. Initial cerebrospinal fluid (CSF) analysis was grossly abnormal. Anti-viral and -bacterial treatments were started. All microbiological tests proved negative and his moxifloxacin was withheld resulting in a complete normalisation of CSF. Drug-induced aseptic meningitis is a diagnosis of exclusion and presents a serious diagnostic dilemma. The decision to withhold medication cannot be taken lightly.
authors.affiliation: The GUIDE Clinic (Genitourinary and Infectious Disease Department), St James Hospital, Dublin, Ireland.
authors.forename: D
authors.initials: D
authors.lastname: Rowley
authors.forename: L
authors.initials: L
authors.lastname: Houlihan
authors.forename: K
authors.initials: K
authors.lastname: McFaul
authors.forename: S
authors.initials: S
authors.lastname: Clarke
authors.forename: F
authors.initials: F
authors.lastname: Lyons
mesh_terms: D000900:Anti-Bacterial Agents / Q000009:adverse effects* / Q000627:therapeutic use; D001372:Aza Compounds / Q000009:adverse effects* / Q000627:therapeutic use; D024841:Fluoroquinolones; D015658:HIV Infections / Q000150:complications*; D006801:Humans; D008297:Male; D008582:Meningitis, Aseptic / Q000134:cerebrospinal fluid / Q000139:chemically induced* / Q000175:diagnosis; D008875:Middle Aged; D000077266:Moxifloxacin; D011804:Quinolines / Q000009:adverse effects* / Q000627:therapeutic use; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents; D001372:Aza Compounds; D024841:Fluoroquinolones; D011804:Quinolines; D000077266:Moxifloxacin
keywords: AIDS; Europe; HIV; antibiotic; aseptic meningitis; drug-induced; hypersensitivity; moxifloxacin; toxicity; viral disease