Pires Sofia Alexandra Pereira, Lemos Ana Pereira, Pereira Ester Preciosa Maio Nunes, Maia Paulo Alexandre da Silva Vilar, Agro João Patrício de Sousa E Alvim Bismarck do
Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal.
Centro Hospitalar de Leiria, Leiria, Portugal.
Rev Paul Pediatr. 2019 Jun 3;37(3):382-385. doi: 10.1590/1984-0462/;2019;37;3;00016. eCollection 2019.
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aseptic meningitis (DIAM) and highlight the importance of early recognition of DIAM, sothat the offending drug can be withdrawn, and recurrences prevented.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.
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.
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.
报告一例诊断为布洛芬诱发脑膜炎的男性青少年病例。我们讨论药物性无菌性脑膜炎（DIAM）的主要病因，并强调早期识别DIAM的重要性，以便停用致病药物并预防复发。儿科年龄组中报道的DIAM病例很少。
一名健康的15岁男孩在服用布洛芬30分钟后因头痛、恶心、头晕、发热、结膜充血和视力模糊就诊于急诊科。在留院期间，他出现呕吐和颈部僵硬。脑脊液分析排除了感染性病因，考虑为DIAM。停药后他完全康复。
DIAM是一种罕见疾病，在无菌性脑膜炎的鉴别诊断中应予以考虑。主要致病因素是非甾体类抗炎药，尤其是布洛芬。根据服药与症状开始之间的时间关联作出怀疑，但始终应排除感染性病因。
