Metronidazole-Induced Aseptic Meningitis during <i>Helicobacter pylori</i> Eradication Therapy
Authors: Sujoy Khan, Basil Sharrack, W.A.C. Sewell
Journal: Annals of Internal Medicine (2007)

Letters6 March 2007Metronidazole-Induced Aseptic Meningitis during Helicobacter pylori Eradication TherapySujoy Khan, MBBS, Basil Sharrack, MD, PhD, and W.A.C. Sewell, MBBS, PhDSujoy Khan, MBBSFrom Scunthorpe General Hospital, Scunthorpe, United Kingdom; Lincoln County Hospital, Lincoln, United Kingdom; and University of Lincoln, Brayford Pool, Lincoln, United Kingdom., Basil Sharrack, MD, PhDFrom Scunthorpe General Hospital, Scunthorpe, United Kingdom; Lincoln County Hospital, Lincoln, United Kingdom; and University of Lincoln, Brayford Pool, Lincoln, United Kingdom., and W.A.C. Sewell, MBBS, PhDFrom Scunthorpe General Hospital, Scunthorpe, United Kingdom; Lincoln County Hospital, Lincoln, United Kingdom; and University of Lincoln, Brayford Pool, Lincoln, United Kingdom.Author, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-146-5-200703060-00017 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Background: Drugs can cause symptomatic meningitis with cerebrospinal fluid (CSF) abnormalities, such as neutrophilic pleocytosis, and increased CSF protein that mimic infection. Nonsteroidal anti-inflammatory drugs (NSAIDs) and antimicrobials are the most common causes of drug-induced aseptic meningitis.Objective: To report a case of a patient who had 3 episodes of aseptic meningitis during eradication therapy for Helicobacter pylori infection.Case Report: A 42-year-old man was admitted in July 2004, reporting headache, nausea, photophobia, and neck stiffness within 2 hours of taking lansoprazole (30 mg), amoxicillin (1 g), and metronidazole (400 mg) combination therapy. He had been diagnosed with viral meningitis ...References1. Jolles S, Sewell WA, Leighton C. Drug-induced aseptic meningitis: diagnosis and management. Drug Saf. 2000;22:215-26. [PMID: 10738845] CrossrefMedlineGoogle Scholar2. Corson AP, Chretien JH. Metronidazole-associated aseptic meningitis [Letter]. Clin Infect Dis. 1994;19:974. [PMID: 7893894] CrossrefMedlineGoogle Scholar3. Meisel-Mikołajczyk F, Rokosz A, Kot K, Zawidzka E, Malchar C, Nowaczyk M, et al. Influence of clindamycin, metronidazole and polymyxin B on the expression of cell adhesion molecules stimulated by endotoxin and enterotoxin of Bacteroides fragilis. Acta Microbiol Pol. 2003;52:361-72. [PMID: 15095923] MedlineGoogle Scholar4. Zaccagni H, Fried J, Cornell J, Padilla P, Brey RL. Soluble adhesion molecule levels, neuropsychiatric lupus and lupus-related damage. Front Biosci. 2004;9:1654-9. [PMID: 14977576] CrossrefMedlineGoogle Scholar5. Pichler WJ. Pharmacological interaction of drugs with antigen-specific immune receptors: the p-i concept. Curr Opin Allergy Clin Immunol. 2002;2:301-5. [PMID: 12130944] CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: From Scunthorpe General Hospital, Scunthorpe, United Kingdom; Lincoln County Hospital, Lincoln, United Kingdom; and University of Lincoln, Brayford Pool, Lincoln, United Kingdom.Disclosures: None disclosed. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited ByDrug-induced meningitis: A review of the literature and comparison with an historical cohort of viral meningitis casesAnthelmintics in DermatologyDrug-Induced Aseptic Meningitis and Other MimicsDrug-Induced Aseptic Meningitis and Other Mimics 6 March 2007Volume 146, Issue 5Page: 395-396KeywordsAntimicrobialsCerebrospinal fluidDrugsGlucoseMeningitisMigraineNSAIDsProteinsVaccines ePublished: 6 March 2007 Issue Published: 6 March 2007 CopyrightCopyright © 2007 by American College of Physicians. All Rights Reserved.PDF DownloadLoading ...