A diagnostic dilemma: drug-induced aseptic meningitis in a 45-year-old HIV-positive man. (March 2014)

• Record Type: Journal Article
• Authors: Rowley, D; Houlihan, L; McFaul, K; Clarke, S; Lyons, F
• Is Part Of: International journal of STD & AIDS. Volume 25:Number 4(2014:Apr.)
• Page Start: 309
• Page End: 311
• Publication Date: 2014-03
• Subjects: HIV -- AIDS -- aseptic meningitis -- drug-induced -- moxifloxacin -- hypersensitivity -- Europe -- antibiotic -- toxicity -- viral disease; Sexually transmitted diseases -- Periodicals; AIDS (Disease) -- Periodicals; 616.951
• DOI: 10.1177/0956462413501157
• Languages: English
• ISSNs: 0956-4624

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.