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Case Reports
. 2019 Jun 3;37(3):382-385.
doi: 10.1590/1984-0462/;2019;37;3;00016. eCollection 2019.

IBUPROFEN-INDUCED ASEPTIC MENINGITIS: A CASE REPORT

[Article in English, Portuguese]
Sofia Alexandra Pereira Pires  1 , Ana Pereira Lemos  2 , Ester Preciosa Maio Nunes Pereira  2 , Paulo Alexandre da Silva Vilar Maia  2 , João Patrício de Sousa E Alvim Bismarck do Agro  2
Affiliations
Case Reports

IBUPROFEN-INDUCED ASEPTIC MENINGITIS: A CASE REPORT

[Article in English, Portuguese]
Sofia Alexandra Pereira Pires et al. Rev Paul Pediatr. .

Abstract
in English, Portuguese

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aseptic meningitis (DIAM) and highlight the importance of early recognition of DIAM, sothat the offending drug can be withdrawn, and recurrences prevented.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.

Objetivo:: Descreve-se o caso de um adolescente do sexo masculino com diagnóstico de meningite asséptica por ibuprofeno. Discutem-se as causas de meningite asséptica induzida por medicamentos (MAIM) e a importância do reconhecimento precoce dessa situação, para que a medicação envolvida seja suspensa e as recorrências prevenidas. Poucos casos foram descritos em idade pediátrica.

Descrição do caso:: Adolescente de 15 anos, gênero masculino, saudável, procurou o serviço de urgência por cefaleia, náuseas, tonturas, febre, hiperemia conjuntival e visão desfocada 30 minutos após o uso de ibuprofeno. Durante a internação, iniciou vômitos e rigidez na nuca. A análise do líquido cefalorraquidiano excluiu causas infeciosas, e considerou-se como diagnóstico mais provável a MAIM. A recuperação foi total após a suspensão do medicamento.

Comentários:: A MAIM é rara, mas deve ser considerada no diagnóstico diferencial de meningite asséptica. A principal causa são os anti-inflamatórios não esteroides, principalmente o ibuprofeno. A suspeita clínica é evocada pela relação temporal entre o uso do medicamento e o início dos sintomas, mas as causas infeciosas devem ser sempre excluídas.

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Conflict of interest statement

The authors declare no conflict of interests.

References

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