Rowley D, Houlihan L, McFaul K, Clarke S, Lyons F
The GUIDE Clinic (Genitourinary and Infectious Disease Department), St James Hospital, Dublin, Ireland.
Int J STD AIDS. 2014 Mar;25(4):309-11. doi: 10.1177/0956462413501157. Epub 2013 Sep 2.
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.
我们描述了一例45岁的人类免疫缺陷病毒（HIV）感染者在服用莫西沙星后发生无菌性脑膜炎的病例。就诊时，他因严重肝毒性正在接受改良方案的结核病治疗；该方案包括8天前开始使用的莫西沙星。初始脑脊液（CSF）分析明显异常。开始了抗病毒和抗菌治疗。所有微生物学检查结果均为阴性，停用了他的莫西沙星，结果脑脊液完全恢复正常。药物性无菌性脑膜炎是一种排除性诊断，会带来严重的诊断困境。停用药物的决定不能轻易做出。
