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阿莫西林诱发的无菌性脑膜炎。

Amoxicillin-Induced Aseptic Meningitis.

作者信息

Sousa Débora, Raimundo Pedro

机构信息

Internal Medicine Department, Hospital da Luz, Lisboa, Portugal.

出版信息

Eur J Case Rep Intern Med. 2020 Apr 1;7(6):001543. doi: 10.12890/2020_001543. eCollection 2020.

Abstract

UNLABELLED

Amoxicillin is a semi-synthetic beta-lactam antibiotic that belongs to the penicillin family. It is the most prescribed antibiotic in the world. It has few side effects, even though hypersensitivity reactions may occur, with potential life-threatening effects. The authors present the case of a 63-year-old male admitted to the emergency department with a 2-week history of fever and occipital headache. The symptoms began after he started antibiotic prophylaxis with amoxicillin for a dental procedure. Cerebrospinal fluid analysis was suggestive of aseptic meningitis and the patient improved quickly after discontinuation of the drug. The patient's previous medical history highlighted a similar episode after he had started taking amoxicillin as part of a scheme for the treatment of a infection. Aseptic meningitis is an extremely rare adverse reaction of amoxicillin, with only 16 cases reported in the literature.

LEARNING POINTS

Aseptic meningitis is a rare side effect of amoxicillin.It is a diagnosis of exclusion and establishing a chronological relationship between the administration of amoxicillin and the onset of clinical symptoms is a key element for the diagnosis.The physiopathology is not well defined, but the consensus is that it is most probably the result of an immunologic hypersensitivity reaction.

摘要

未标注

阿莫西林是一种半合成β-内酰胺抗生素,属于青霉素类。它是世界上处方量最大的抗生素。它副作用较少,尽管可能会发生超敏反应,有潜在的危及生命的影响。作者介绍了一名63岁男性的病例,该患者因发热和枕部头痛2周入院急诊科。这些症状在他开始用阿莫西林进行牙科手术预防性抗生素治疗后出现。脑脊液分析提示为无菌性脑膜炎,停药后患者迅速好转。患者既往病史显示,在他开始服用阿莫西林作为治疗某种感染方案的一部分后曾有过类似发作。无菌性脑膜炎是阿莫西林极为罕见的不良反应,文献中仅报道过16例。

学习要点

无菌性脑膜炎是阿莫西林罕见的副作用。它是一种排除性诊断,在阿莫西林给药与临床症状发作之间建立时间顺序关系是诊断的关键要素。其病理生理学尚未明确界定,但共识是它很可能是免疫超敏反应的结果。

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Amoxicillin-Induced Aseptic Meningitis.阿莫西林诱发的无菌性脑膜炎。
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本文引用的文献

2
Mollaret meningitis.莫拉雷脑膜炎
J Neurol Sci. 2019 Jan 15;396:148-149. doi: 10.1016/j.jns.2018.11.018. Epub 2018 Nov 17.
3
Drug-induced aseptic meningitis: a mini-review.药物性无菌性脑膜炎:一篇综述短文
Fundam Clin Pharmacol. 2018 Jun;32(3):252-260. doi: 10.1111/fcp.12349. Epub 2018 Mar 9.
4
Amoxicillin-induced acute aseptic meningitis.阿莫西林致急性无菌性脑膜炎。
J Clin Neurosci. 2011 Mar;18(3):443-4. doi: 10.1016/j.jocn.2010.07.122. Epub 2011 Jan 15.
5
Amoxicillin-induced aseptic meningoencephalitis.阿莫西林致无菌性脑膜脑炎。
Int J Gen Med. 2010 Jul 21;3:157-62. doi: 10.2147/ijgm.s11577.

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