scholarly journals Drug-Induced Aseptic Meningitis Following Spinal Anesthesia

2019 ◽  
Author(s):  
Ricardo Paquete Oliveira ◽  
Mafalda Teixeira ◽  
Sofia Cochito ◽  
Ana Furtado ◽  
Bruno Grima ◽  
...  
Keyword(s):  
Cerebrospinal Fluid ◽  
Bacterial Meningitis ◽  
Spinal Anesthesia ◽  
Aseptic Meningitis ◽  
Cerebrospinal Fluid Analysis ◽  
Drug Induced ◽  
Neurological Sequelae ◽  
Fluid Analysis ◽  
Empirical Antibiotics ◽  
Uncommon Complication

Meningitis is a very uncommon complication of spinal anesthesia, and drug-induced aseptic meningitis (DIAM) is even rarer. We present two cases of DIAM following spinal anesthesia with bupivacaine and ropivacaine, respectively. The patients presented shortly after the procedure with typical meningitis symptoms. Since CSF (cerebrospinal fluid) analysis could not initially exclude bacterial meningitis, they were started on empirical antibiotics. CSF was subsequently found to be negative for viruses and bacteria in both cases, and antibiotics were promptly stopped. Both patients improved rapidly and without neurological sequelae. While it remains a diagnosis of exclusion, it is important to be aware of DIAM as recognition of the condition can lead to shorter admission times and avoid unnecessary use of antibiotics.

Immunoglobulin-Induced Aseptic Meningitis in Juvenile Dermatomyositis: A Case Report

2021 ◽  
Author(s):  
Oi Man CHAN ◽  
Chon In Kuok ◽  
Hoi Man Roanna Yeung ◽  
Winnie Kwai Yu Chan
Keyword(s):  
Adverse Effect ◽  
Cerebrospinal Fluid ◽  
Aseptic Meningitis ◽  
Juvenile Dermatomyositis ◽  
Cerebrospinal Fluid Analysis ◽  
Ivig Infusion ◽  
Case Presentation ◽  
Neurological Sequelae ◽  
Fluid Analysis ◽  
Chinese Girl

Abstract Background: Aseptic meningitis is a known but unusual serious adverse effect of intravenous immunoglobulin (IVIG). It usually resembles infectious meningitis which makes diagnosis challenging. Case presentation: We report a five-and-a-half-year-old Chinese girl with juvenile dermatomyositis presented with signs of meningismus 21 hours after the initiation of IVIG infusion. Her blood work at diagnosis showed neutrophilia and lymphopenia. The cerebrospinal fluid analysis demonstrated neutrophilic pleocytosis, hyperproteinorrachia and normoglycorrhachia. All microbiological tests were negative. The child recovered fully within 72hours without neurological sequelae.Conclusion: IVIG-induced aseptic meningitis remains a diagnosis of exclusion. Although it is rare, paediatricians should be aware of this complication and avoid unnecessary investigation or treatment.

scholarly journals Benign Recurrent Aseptic Meningitis (Mollaret’s Meningitis) in an Elderly Male: A Case Report

2021 ◽  
Vol 59 (241) ◽  
pp. 916-918
Author(s):  
Swati Chand ◽  
Sangharsha Thapa ◽  
Khusal Gautam ◽  
Anu Radha Twayana ◽  
Maryrose R.Laguio-Vila ◽  
...  
Keyword(s):  
Polymerase Chain Reaction ◽  
Cerebrospinal Fluid ◽  
Aseptic Meningitis ◽  
Acute Onset ◽  
Chain Reaction ◽  
Elderly Male ◽  
Cerebrospinal Fluid Analysis ◽  
Fluid Analysis ◽  
Polymerase Chain ◽  
Mollaret's Meningitis

Mollaret’s meningitis is an aseptic recurrent benign lymphocytic meningitis lasting 2-5 days and occurs over years with spontaneous complete resolution of symptoms between episodes. An 88 years-old-male presented with acute onset headache, lethargy and altered sensorium after a recent ear infection. He had multiple similar episodes in the past, each preceded by ear or sinus infection with cerebrospinal fluid finding consistent with aseptic meningitis. However, no specific causative agent was ever identified. He was confused, disoriented and lethargic with normal vitals and systemic examination. Blood tests showed leukocytosis with neutrophilia. Cerebrospinal fluid analysis revealed increased cell count with lymphocyte predominance, elevated protein and negative polymerase chain reaction. Magnetic resonance imaging of brain showed chronic small vessel ischemic changes. He fulfilled the Bruyn’s criteria for clinical diagnosis. He was empirically administered acyclovir during hospitalization and was discharged without prophylactic antiviraldue to negative cerebrospinal fluid analysis, culture, and multiplex polymerase chain reaction.

scholarly journals Cerebrospinal fluid analysis in infectious diseases of the nervous system: when to ask, what to ask, what to expect

2013 ◽  
Vol 71 (9B) ◽  
pp. 693-698 ◽  
Author(s):  
Luis dos Ramos Machado ◽  
Jose Antonio Livramento ◽  
Liliana Scaff Vianna
Keyword(s):  
Cerebrospinal Fluid ◽  
Nervous System ◽  
Bacterial Meningitis ◽  
Infectious Diseases ◽  
Acute Bacterial Meningitis ◽  
Degenerative Diseases ◽  
Cerebrospinal Fluid Analysis ◽  
Fluid Analysis ◽  
Csf Analysis ◽  
The Difference

Cerebrospinal fluid (CSF) analysis very frequently makes the difference to the diagnosis, not only in relation to infections but also in other diseases of the nervous system such as inflammatory, demyelinating, neoplastic and degenerative diseases. The authors review some practical and important features of CSF analysis in infectious diseases of the nervous system, with regard to acute bacterial meningitis, herpetic meningoencephalitis, neurotuberculosis, neurocryptococcosis, neurocysticercosis and neurosyphilis.

scholarly journals Comparative analysis between the profile of cerebrospinal liquid (CSF) and clinical evolution in patients with bacterial meningitis

2021 ◽  
Author(s):  
Clara Kimie Miyahira ◽  
Vania Maria Sabadoto Brienze
Keyword(s):  
Central Nervous System ◽  
Cerebrospinal Fluid ◽  
Bacterial Meningitis ◽  
Medical Records ◽  
Signs And Symptoms ◽  
Cerebrospinal Fluid Analysis ◽  
Fluid Analysis ◽  
Serious Infection ◽  
Cerebrospinal Fluid Examination ◽  
The Central Nervous System

Background: Bacterial meningitis is a serious infection that occurs in the Central Nervous System, which presents important morbidity and mortality, mainly in children. The main bacterial agents causing meningitis in the community are Haemophilus influenzae, Neisseria meningitidis and Streptococcus pneumoniae. Specific signs and symptoms suggest meningitis and cerebrospinal fluid analysis is the main exam leading to diagnosis. Objectives: To analyze the behavior of cerebrospinal fluid during the evolution of the patient with bacterial meningitis. Methods: A retrospective study revised the medical records of patients with bacterial meningitis confirmed by cerebrospinal fluid examination in the Base Hospital of São José do Rio Preto from January 1996 to December 2002. Results: in the 63 Patients, there were 18 cases (28.6%) of S. pneumoniae, 20 cases (31.7%) of H. influenzae, 12 cases (19%) of N.meningitides B and 13 (20.6%) cases of N. meningitidis C. In the 18 patients with pneumococcus, 10 (55.6%) were discharged and 8 (44.4%) died. In the 20 patients with HIB, only 3 (15%) died, there was no death patients with meningococcus B and C. Conclusion: There was no difference statistics in the cerebrospinal fluid of the patients who were discharged and those who died.

scholarly journals IBUPROFEN-INDUCED ASEPTIC MENINGITIS: A CASE REPORT

2019 ◽  
Vol 37 (3) ◽  
pp. 382-385 ◽  
Author(s):  
Sofia Alexandra Pereira Pires ◽  
Ana Pereira Lemos ◽  
Ester Preciosa Maio Nunes Pereira ◽  
Paulo Alexandre da Silva Vilar Maia ◽  
João Patrício de Sousa e Alvim Bismarck do Agro
Keyword(s):  
Aseptic Meningitis ◽  
Early Recognition ◽  
Conjunctival Hyperemia ◽  
Cerebrospinal Fluid Analysis ◽  
Drug Induced ◽  
Blurred Vision ◽  
Neck Stiffness ◽  
Fluid Analysis ◽  
Causative Agents ◽  
Inflammatory Drugs

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.

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