Mondon M, Ollivier L, Daumont A
Fédération d'endocrinologie, hôpital de l'Antiquaille, 1, rue de l'Antiquaille, 69321 Lyon, France.
Rev Med Interne. 2002 Sep;23(9):784-7. doi: 10.1016/s0248-8663(02)00675-6.
Drug-induced aseptic meningitis (DIAM) has been reported as an uncommon adverse reaction to treatment, nonsteroidal anti-inflammatory drugs (NAIDS) stand for most of the published cases. EXEGIS: Our observation reports the first case of a meningeal syndrome with fever, after the administration of ornidazole, with biological aseptic meningitis with lymphocyte prodominance. Spontaneous recovery occurred within a few days and without sequelae. It involved a patient with endocarditis and revealing an intramucous sigmoid adenocarcinoma. The rest of the infection tests was negative.
We concluded that we were in the presence of a DIAM, with ornidazole as the most probable implicated agent. This diagnosis is suggested in front of a recurring meningeal syndrome without any other apparent etiology, hence the importance of the questioning of the patient. Pending objective evidence usually provided by rechallenge, an antibiotic therapy is necessary, because it is, above all, a diagnosis of exclusion.
药物性无菌性脑膜炎（DIAM）已被报道为一种不常见的治疗不良反应，非甾体类抗炎药（NSAIDs）占已发表病例的大多数。病例报告：我们的观察报告了首例在使用奥硝唑后出现发热性脑膜综合征的病例，伴有以淋巴细胞为主的生物性无菌性脑膜炎。数天内自发恢复且无后遗症。该病例涉及一名患有心内膜炎并发现黏膜下乙状结肠腺癌的患者。其余感染检测均为阴性。
我们得出结论，这是一例DIAM，奥硝唑最有可能是相关药物。在出现反复的脑膜综合征且无任何其他明显病因时应考虑这一诊断，因此询问患者用药情况很重要。在通常由再次用药提供客观证据之前，抗生素治疗是必要的，因为这首先是一种排除性诊断。
需注意，原文中“EXEGIS”疑似有误，可能是“CASE REPORT”，译文按“病例报告”翻译。
