IBUPROFEN-INDUCED ASEPTIC MENINGITIS: A CASE REPORT

ABSTRACT Objective: To report a case of a male adolescent with the diagnosis of ibuprofen-induced meningitis. We discuss themain causes of drug-induced aseptic meningitis (DIAM) and highlight the importance of early recognition of DIAM, sothat the offending drug can be withdrawn, and recurrences prevented. Only few DIAM cases have been reported in pediatric age. Case description: A healthy 15-year-old boy presented to the emergency department with headache, nausea, dizziness, fever, conjunctival hyperemia and blurred vision 30 minutes after ibuprofen-intake. During his stay, he developed emesis and neck stiffness. Cerebrospinal fluid analysis excluded infectious causes, and DIAM was considered. He totally recovered after drug withdrawal. Comments: DIAM is a rare entity, that should be considered in the differential diagnosis of an aseptic meningitis. The major causative agents are nonsteroidal anti-inflammatory drugs, particularly ibuprofen. Suspicion is made by the chronologic link between drug intake and the beginning of symptoms, but infectious causes should always be ruled out.

摘要 研究目的：报告1例布洛芬诱导性脑膜炎的男性青少年病例。本文讨论药物性无菌性脑膜炎（drug-induced aseptic meningitis, DIAM）的主要致病原因，并强调早期识别该病症的重要性，以便及时停用致病药物，预防病情复发。目前儿童群体中报道的药物性无菌性脑膜炎病例较为少见。
病例资料：1名健康的15岁男性患者，在服用布洛芬30分钟后，因头痛、恶心、头晕、发热、结膜充血及视物模糊前往急诊就诊。住院期间，患者出现呕吐及颈强直症状。脑脊液分析排除了感染性病因，遂考虑为药物性无菌性脑膜炎。停药后患者完全康复。
讨论：药物性无菌性脑膜炎是一种罕见病症，在无菌性脑膜炎的鉴别诊断中应将其纳入考量。其主要致病药物为非甾体类抗炎药（nonsteroidal anti-inflammatory drugs, NSAIDs），尤以布洛芬最为常见。诊断的关键线索为服药与症状发作之间的时间关联，但需始终先行排除感染性病因。